MedicaidCoverageMedium impact
Outpatient Prospective Payment System and Inpatient Only Procedures
Connecticut Medicaid (HUSKY Health)·CT·Reimbursement
We identified it
Jun 20, 2026
Summary
The Department of Social Services is requesting hospitals review CMAP's Addendum B for procedures marked as 'inpatient only' (status indicator 'C') that could potentially be performed in outpatient settings. Hospitals can submit procedure codes with justification for DSS review to potentially expand outpatient reimbursement eligibility.
Action Required
Immediately: Billing team and clinical staff should review CMAP's Addendum B to identify procedures with status indicator 'C' (inpatient only) that your facility believes can be safely performed in outpatient settings. Compile a list of these procedure codes with brief clinical justification and submit to ctxixhosppay@hpe.com for DSS review. This could potentially expand reimbursable outpatient services.