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Update to the Billing Requirements for Evaluations and Re-Certifications Performed by Home Health Agencies and Access Agencies

Connecticut Medicaid (HUSKY Health)·CT · Family Medicine, Internal Medicine, General Practice·Provider Bulletin
Effective date
Apr 1, 2017
We identified it
Jun 20, 2026
Days to comply

Summary

Home health agencies and access agencies must stop billing deprecated codes S9123 and S9124 for evaluations and re-certifications, and instead use T1001 for evaluations or G0162 for 60-day re-certifications. Financial adjustments will be made upon audit for agencies continuing to use the old codes after the effective date.

Action Required

Action needed
Immediately: Home health agencies and access agencies must update billing systems to use T1001 for evaluations and G0162 for 60-day re-certifications instead of S9123/S9124. Update staff training on proper code usage with approved modifiers (TD, TT, TG, TE, TH). Obtain prior authorization for multiple T1001 evaluations within same calendar year. Failure to comply will result in financial adjustments upon audit.

Affected Billing Codes

T1001
G0162
S9123
S9124