MedicaidBilling CodesMedium impact
CMS National Correct Coding Initiative (NCCI)
Connecticut Medicaid (HUSKY Health)·CT · Psychiatry·Coding
Effective date
Jan 1, 2013
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid has implemented CMS National Correct Coding Initiative (NCCI) procedure-to-procedure edits for behavioral health clinicians, which prevent payment for certain code pairs billed together on the same date of service. Modifiers 25 and 59 can be used to bypass some edits when services are distinct and separately identifiable.
Action Required
Immediately: Behavioral health billing team must access CMS NCCI Tables Manual at http://www.cms.gov/NationalCorrectCodInitEd/ to identify restricted procedure code pairs. Update billing system to flag potential NCCI edits and train staff on proper use of modifiers 25 and 59 when billing distinct services on the same date. Check NCCI tables regularly for updates as they affect claim payments.