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Performing Provider Required for Select Clinic Providers pdf
Connecticut Medicaid (HUSKY Health)·CT · Family Medicine, Pediatrics, OB-GYN·Provider Bulletin
Effective date
Nov 1, 2018
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (HUSKY Health) now requires all performing providers at Family Planning, School-Based Health, and Medical Clinics to be enrolled in CMAP and have their NPI included on all claims. Claims without valid performing provider NPIs will be denied starting November 1, 2018.
Action Required
Before November 1, 2018: All performing providers must enroll in Connecticut Medical Assistance Program (CMAP) using the enrollment wizard at www.ctdssmap.com. Billing team must update claim submission process to include performing provider NPIs in NM109 segment (Loop ID 2420) for all electronic claims. Already enrolled providers must associate themselves with clinic organizations using 'Maintain Organization Members' panel. Failure to include valid performing provider NPIs will result in claim denials with EOB codes 0231, 1007, 1008, 1010, or 1011.