MedicaidReimbursementMedium impact
Change in Pricing Methodology for Patient Lifts on the MEDS Fee Schedule pdf
Connecticut Medicaid (HUSKY Health)·CT · PM&R (Physical Medicine & Rehab), Physical Therapy, Occupational Therapy·Reimbursement
Effective date
Apr 1, 2018
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid changed the pricing methodology for patient lifts (HCPCS E0639 and E0640) from a fixed fee schedule to manual pricing based on actual acquisition cost plus 15%. Providers must now submit actual acquisition cost documentation with prior authorization requests or face claim denials.
Action Required
Immediately for Connecticut Medicaid patients: DME providers must submit actual acquisition cost (AAC) documentation with all prior authorization requests for patient lifts E0639 and E0640. Update billing procedures to calculate reimbursement as AAC plus 15%, with maximum reimbursement capped at $5,725.00. Ensure PA requests include complete documentation within 20 business days or claims will be automatically denied.