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Use of Pro-Rated Service Codes pdf
Connecticut Medicaid (HUSKY Health)·CT · Family Medicine, Internal Medicine, Geriatrics·Provider Bulletin
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid requires providers to use specific pro-rated procedure codes and obtain prior authorization when full 12/24 hour personal care shifts cannot be completed. Eight different service types have designated pro-rated codes that must be used instead of full shift codes to avoid claim denials.
Action Required
Immediately: Billing team must update system to use pro-rated codes (1225Z, 1227Z, 3020Z, 3022Z, 3024Z, 3025Z, 3030Z, 3033Z) instead of full shift codes when personal care services cannot be completed. Providers must contact case managers when shifts are incomplete and obtain prior authorization for pro-rated codes before billing. Update billing software to require PA for all pro-rated codes. Claims will be denied without proper authorization.