MedicaidBilling CodesHigh impact
DSS Important Message - Hospital Monthly Important Message - 07.20.2026
Connecticut Medicaid (HUSKY Health)·CT · Psychiatry·Provider Bulletin
Effective date
Jul 1, 2026
We identified it
Jul 28, 2026
Summary
Connecticut DSS is updating CMAP Addendum B V27.2 effective July 1, 2026 to incorporate 2026 HCPCS code changes (additions, deletions, descriptions). Updated PDF and Excel files will be posted July 28, 2026. Payment rate changes for procedure codes with status indicators G, K, or K1 were already loaded July 9, 2026. Additionally, psychiatric Collaborative Care Model (CoCM) coverage begins July 1, 2026 for HUSKY Health members, and clinical review criteria are being updated. Prior authorization requirements for inpatient elective admissions are clarified, with emphasis on timely authorization updates to prevent claim denials.
Action Required
REQUIREMENTS:
By July 28, 2026: Billing team must download and implement the updated CMAP Addendum B V27.2 and new procedure codes from www.ctdssmap.com Hospital Modernization page. Review all codes marked with status indicators "G", "K", "K1", "New", or "X" to identify payment rate changes, new procedures, and procedure code/status indicator modifications. Update billing software fee schedules and code mapping accordingly to ensure correct reimbursement effective July 1, 2026 forward.
By July 1, 2026: Billing and authorization staff must implement updated clinical review criteria per Provider Bulletin 2026-38. Review eligibility rules for any medical services or items affected by policy changes.
Immediately: Providers submitting inpatient elective authorizations must contact Community Health Network of Connecticut (CHNCT) at 1-800-440-5071 for any planned admission date changes. CHNCT will update authorization and send corrected prior authorization to Gainwell for processing. Failure to update authorization will result in claim denials. Authorization start/end dates must match actual admission date.
Effective July 1, 2026 forward: Billing team must ensure psychiatric Collaborative Care Model (CoCM) services for HUSKY Health A, B, C, and D members are billed with correct codes and billing indicators. Reference Provider Bulletin 2026-36 for CoCM billing requirements.
Ongoing: For claim denials related to prior authorization (EOB code 3004), verify that prior authorization has been in the system for at least 24 hours (48 hours for Carelon PAs) before resubmitting. Allow sufficient time for PA entry into interChange system before claim submission.