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March 2017 interChange Newsletter

Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Mar 1, 2017
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid now requires hospitals to verify that physicians obtained prior authorization for separately reimbursable professional services before billing for the technical component. If physician PA is missing, hospital outpatient claims will deny with EOB code 3013.

Action Required

Action needed
Immediately: Hospital billing teams must verify physician prior authorization exists before submitting outpatient claims for services requiring PA. Check fee schedules at www.ctdssmap.com to identify which services require physician PA. Claims submitted without valid physician PA on file will deny with EOB code 3013. Update billing workflows to include PA verification step.