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interChange Provider Important Message

Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Jul 1, 2016
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut DSS is implementing major changes for hospitals including transitioning to APC payment methodology on July 1, 2016, requiring hospitals to enroll practitioner groups for outpatient professional services billing, and updating various billing procedures and fee schedules.

Action Required

Action needed
By July 1, 2016: Hospitals must enroll as practitioner groups in Connecticut Medical Assistance Program (CMAP) to bill outpatient professional services separately from OPPS. Ensure performing providers are enrolled under the practitioner group. Update billing systems to use new APC methodology instead of Revenue Center Codes. Review and implement new drug testing codes G0477-G0483 replacing discontinued G6030-G6058 range. Verify prior authorization requirements for new molecular pathology codes 81162-81595. Submit retroactive eligibility authorization requests within 30 days of eligibility being granted.

Affected Billing Codes

80300
80377
G0477
G0478
G0479
G0480
G0481
G0482
G0483
G6030
G6058
G0431
G0434
81162
81170
81218
81219
81272
81276
81311
81314
81412
81493
81525
81595