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MedicaidBilling CodesMedium impact

Subsequent Observation Procedure Codes (99224-99226)

Connecticut Medicaid (HUSKY Health)·CT · Internal Medicine, Family Medicine·Provider Bulletin
Effective date
Sep 14, 2016
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid added three new subsequent observation care codes (99224-99226) effective September 14, 2016, with specific time requirements and a 48-hour reimbursement limit. Providers can bill comparable E&M codes (99213-99215) for observation services performed between July 1 and September 13, 2016.

Action Required

Action needed
Immediately: Billing team must add codes 99224, 99225, and 99226 to billing system for Connecticut Medicaid observation services. Update system to prevent billing observation codes beyond 48 hours. Train providers on time documentation requirements (15, 25, or 35 minutes at bedside). Claims billed beyond 48-hour limit may result in financial adjustments.

Affected Billing Codes

99224
99225
99226
99213
99214
99215