MedicaidCoverageMedium impact
2026.42 - Provider Bulletin - HUSKY Limited Benefit (LB) – Family Planning Limited Coverage
Connecticut Medicaid (HUSKY Health)·CT · OB-GYN, Family Medicine, Internal Medicine +3 more·Provider Bulletin
We identified it
Sep 21, 2026
Summary
This is a refresher bulletin on Connecticut's HUSKY Limited Benefit (LB) Family Planning Limited Coverage program, reiterating coverage rules, eligible services, required diagnosis codes, and billing requirements for family planning and family planning-related services. Billing teams must ensure all claims include applicable family planning diagnosis codes as primary diagnosis and only bill covered procedures per fee schedule footers, or claims will be denied.
Action Required
Immediately: Billing team must verify that all HUSKY LB Family Planning Limited Coverage claims include a qualifying family planning or family planning-related diagnosis code as the primary diagnosis (Box 24e on professional claims; header on institutional claims). Update billing system validation rules to enforce this requirement. Review applicable fee schedules at www.ctdssmap.com to identify covered procedure codes for each provider type (physicians, PAs, APRNs, CNMs, ASCs, labs, outpatient hospitals). Train staff that claims submitted with non-covered procedure codes or without qualifying diagnosis codes will be denied. For pharmacy claims, ensure NDCs include required family planning diagnosis code and any PrEP/PEP-specific diagnosis codes per pharmacy program publications. Reference PB 2012-07 and Fee Schedule Table 3b for complete list of covered services and diagnosis codes.