MedicaidBilling CodesHigh impact
Hospital Monthly Important Message
Connecticut Medicaid (HUSKY Health)·CT · Radiology, Physical Therapy, Occupational Therapy +1 more·Provider Bulletin
Effective date
Jan 1, 2017
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (CMAP) has implemented multiple billing updates including new JW modifier requirements for discarded single-use drugs effective January 1, 2017, updated CPT codes for mammography and physical/occupational therapy, increased outlier threshold to $3,825, and various MUE unit limits for specific procedure codes.
Action Required
Immediately: Update billing system to require JW modifier on separate line items for discarded portions of single-use drugs/biologicals. Update mammography and PT/OT evaluation CPT codes per 2017 changes. Verify MUE unit limits are updated for listed procedure codes. For Kyleena IUD, bill using C9399 with NDC until unique HCPCS assigned. Claims exceeding MUE limits require written appeal to DSS with medical documentation.