MedicaidCoverageMedium impact
Autism Spectrum Disorder (ASD) Evaluation and Treatment Services Provided by Medical Clinics, Rehabilitation Clinics and Board Certified Behavior Analysts
Connecticut Medicaid (HUSKY Health)·CT · Pediatrics, Family Medicine, Psychiatry +2 more·Provider Bulletin
Effective date
Jan 1, 2015
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid expanded coverage for Autism Spectrum Disorder (ASD) evaluation and treatment services for members under 21, including medical clinics, rehabilitation clinics, and Board Certified Behavior Analysts. This policy clarifies billing procedures, provider qualifications, and reimbursement rates for comprehensive ASD services.
Action Required
Immediately: Billing teams at medical and rehabilitation clinics in Connecticut must verify Medicaid provider enrollment for ASD services. Update billing procedures to use existing E&M codes (99201-99255) for medical/physical evaluations. Ensure proper documentation requirements are met for comprehensive diagnostic evaluations and behavior assessments. Review reimbursement rates which match behavioral health clinic rates.