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MedicaidReimbursementMedium impact

Rates for Rental Items Used with Continuous Positive Airway Pressure (CPAP) and Respiratory Assist Devices, Bi-level Pressure (BiPAP) pdf

Connecticut Medicaid (HUSKY Health)·CT · Pulmonology, Sleep Medicine·Reimbursement
Effective date
Aug 1, 2018
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid corrected the rental rate for heated humidifiers (E0562) from $24.32 to $13.28 and updated reimbursement rates for CPAP/BiPAP supplies. The policy allows separate billing of PAP supplies during rental periods but reduces rates to ensure cost neutrality.

Action Required

Action needed
Billing team must update fee schedules with new CPAP/BiPAP supply rates for Connecticut Medicaid claims. Update billing system to reflect corrected E0562 rental rate of $13.28 and new rates for all listed PAP supply codes. Note that A7027 has a quantity limit of 1 per 3 months and RB modifier is discontinued for A7027, E0561, and E0562. Previously submitted claims will automatically reprocess.

Affected Billing Codes

A4604
A7027
A7028
A7029
A7030
A7031
A7032
A7033
A7034
A7035
A7036
A7037
A7038
A7039
A7044
A7045
A7046
E0561
E0562