MedicaidBilling CodesMedium impact
Additional Guidance on the Use of the Home Health SOC/ROC and Recertification Service Codes for CHC, ABI, PCA and Autism Waiver Clients pdf
Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
We identified it
Jun 20, 2026
Summary
Connecticut DSS clarified billing guidance for home health agencies serving waiver clients, specifying when to use Start of Care/Resumption of Care code T1001 versus 60-day recertification code G0162. The policy recommends annual prior authorization for 12 units minimum for recertification visits and provides specific billing instructions for clients returning after hospitalization.
Action Required
Immediately: Home health billing teams must update billing procedures to properly distinguish between T1001 (Start of Care/Resumption of Care) and G0162 (60-day recertification) codes for CHC, ABI, PCA, and Autism waiver clients. Request annual prior authorization for minimum 12 units for recertification visits (2 units per visit for 6 visits annually). Update billing protocols for post-hospitalization scenarios to use T1001 for resumption of care and G0162 within 60 days thereafter. Train staff on proper code selection based on Medicare vs Medicaid coverage status.