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Corrected and Revised - Reductions and Adjustments to Payment for Durable Medical Equipment (DME) to Remain Compliant with Federal Law and Additional Reimbursement Reductions to Medical Equipment, Devices and Supplies (MEDS) pdf

Connecticut Medicaid (HUSKY Health)·CT · Orthopedics, PM&R (Physical Medicine & Rehab), Physical Therapy +2 more·Reimbursement
Effective date
Apr 1, 2018
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid is reducing reimbursement rates for Durable Medical Equipment (DME) and Medical Equipment, Devices and Supplies (MEDS) to comply with federal law requiring rates not exceed Medicare Part B amounts. Rates are being set to 100% of the lowest applicable Medicare fee, including competitive bid pricing, representing significant payment reductions for most codes.

Action Required

Action needed
By April 1, 2018: Billing team must update fee schedules in billing system to reflect new reduced Medicaid reimbursement rates for all DME and MEDS procedure codes. Download updated fee schedules from www.ctdssmap.com and implement new oxygen flow rate modifiers (QA, QB, QE, QF, QG, QR). Update billing software with revised rates to ensure accurate claim submissions and financial projections.

Affected Billing Codes

A7007
A7009
A7017
E0100
E0105
E0110
E0111
E0112
E0113
E0114
E0116
E0130
E0135
K0108