MedicaidReimbursementMedium impact
Changes to the Obstetric (OBS) and Facility Obstetric (FTO) Rate Types
Connecticut Medicaid (HUSKY Health)·CT · OB-GYN, Family Medicine·Reimbursement
Effective date
Jul 1, 2015
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid increased reimbursement rates for obstetric services to 145% of 2007 Medicare rates and re-established coverage for obstetric radiology services at 110% for high-risk pregnancies. Changes are retroactive to July 1, 2015.
Action Required
No immediate action required: Connecticut Medicaid will automatically adjust OBS rates retroactively to July 1, 2015. For obstetric radiology claims (CPT 76801-76802, 76805, 76810-76812, 76815, 76817, 76818): Billing team must verify high-risk pregnancy diagnosis codes are included as primary diagnosis on claim details to qualify for OBS rate reimbursement. Use ICD-9 codes for July-September 2015 dates of service, ICD-10 codes for October 2015 forward. Claims not meeting criteria will be reimbursed at PRA rate.