MedicaidBilling CodesHigh impact
Outpatient Hospital Modernization – Behavioral Health Services
Connecticut Medicaid (HUSKY Health)·CT · Psychiatry·Provider Bulletin
Effective date
Jul 1, 2016
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid is modernizing reimbursement for outpatient hospital behavioral health services, moving away from APC methodology to fixed fees based on revenue center codes and HCPCS/CPT combinations. Hospitals must use specific RCC and procedure code combinations for routine BH services, intermediate programs (IOP, PHP, EDT), and other specialized services.
Action Required
By July 1, 2016: Billing teams at Connecticut hospitals must update billing systems to use specific Revenue Center Code (RCC) and procedure code combinations for all behavioral health services. Update encounter forms to include RCC requirements (900-919, 905-907, 913, 901, 953) paired with appropriate CPT/HCPCS codes. Configure systems to use outpatient mental health (OMH) rate type or outpatient enhanced care (OEC) rate type for Enhanced Care Clinics. Train staff on new medication management billing rules and partial day billing using modifier 52 for intermediate services. Claims using old methodology will not be reimbursed properly under the new OPPS system.