MedicaidPrior AuthMedium impact
Addition of Criteria for Facial Feminization Procedures to the Gender Reassignment Surgery Policy
Connecticut Medicaid (HUSKY Health)·CT · Plastic Surgery, ENT (Ear, Nose & Throat), Oral & Maxillofacial Surgery·Provider Bulletin
Effective date
Jun 1, 2017
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (HUSKY Health) is adding specific criteria for facial feminization procedures under their Gender Reassignment Surgery Policy, effective June 1, 2017. Prior authorization will be required for these procedures with enhanced clinical documentation requirements.
Action Required
By June 1, 2017: Billing team must ensure all facial feminization procedure claims for Connecticut Medicaid patients include prior authorization using the Outpatient Prior Authorization Request form from www.ct.gov/husky. Providers must submit comprehensive clinical documentation supporting medical necessity with initial PA requests to avoid 20-day pending periods and potential denials. Contact CHNCT at 1-800-440-5071 for PA process questions.