MedicaidReimbursementHigh impact
2026.34 - Provider Bulletin - Rate Increases to Select Procedure Codes for Optometry Services
Connecticut Medicaid (HUSKY Health)·CT · Optometry·Reimbursement
Effective date
Jul 1, 2026
We identified it
Jul 10, 2026
Summary
Connecticut Medical Assistance Program (CMAP) is increasing reimbursement rates for eight optometry procedure codes effective July 1, 2026. The rates for these codes will now match physician reimbursement rates under CMAP. Billing teams must update fee schedules in their billing systems to reflect the new rates for CPT codes 92004, 92014, 92015, and 92250 with applicable modifiers.
Action Required
By June 28, 2026: Billing team must download and implement the updated CMAP fee schedule from www.ctdssmap.com to reflect new reimbursement rates for CPT codes 92004, 92014, 92015, and 92250 (with modifiers DEF, FTD, 26, and TC as applicable). Update all billing software, fee schedule tables, and claim submission systems in-house to ensure claims submitted on or after July 1, 2026 use the correct rates. Verify that modifier-specific rates are properly configured in the system (e.g., 92004 DEF at 91.24, 92004 FTD at 56.09). Failure to update rates will result in underpayment or claim denials. Contact Provider Assistance Center at 1-800-842-8440 (Mon-Fri, 8 AM-5 PM) with questions.