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Home Health Providers - Instructions for Claim Denials with procedure code T1001 and Explanation of Benefit (EOB) Code 6527 pdf

Connecticut Medicaid (HUSKY Health)·CT·Coding
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

Home health providers who previously received claim denials for second T1001 nursing assessments (EOB code 6527) for dates of service April 1-August 31, 2017 can now resubmit those claims without prior authorization for payment. Claims from September 1, 2017 forward still require prior authorization for the second T1001 in a calendar year.

Action Required

Action needed
Immediately: Home health billing teams must resubmit previously denied claims for procedure code T1001 with EOB code 6527 for dates of service April 1, 2017 through August 31, 2017. Resolve any other claim denials before resubmission. Claims will not be automatically reprocessed and must be manually resubmitted for payment.

Affected Billing Codes

T1001