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Connecticut Medicaid (HUSKY Health)Medicaid · Billing Codes · Provider Bulletin · CT · Pharmacy, Pathology, Endocrinology +1 moreMedium impact

DSS Important Message - Hospital Monthly Important Message - 10.19.2026

Effective date
Nov 11, 2026
Identified
Oct 29, 2026

Summary

Connecticut's Department of Social Services posted its hospital important message for Medicaid (CMAP) providers, updated 10/19/2026, covering several changes with different dates. Some are already in effect as of today, including the October 1, 2026 ICD-10 and HCPCS updates and the October 13, 2026 diagnosis code requirement for gender-affirming care, while the Addendum B and new, changed or deleted procedure code updates and the new 3M grouper are scheduled for November 2026 (the grouper and Addendum B dates are described as tentative). The message also lists hospital re-enrollment due dates running from December 2026 to March 2027, and the source is a recent DSS notice that PolicyChanges found in October 2026.

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What to do

Action · 15 steps
01Already effective Oct.
0213, 2026: Billing team should add a diagnosis code to every CMAP claim for gender-affirming care services, including pharmacotherapy, in charge entry, as Provider Bulletin 2026-51 requires.
03Already effective Oct.
041, 2026: Confirm that the lab fee schedule changes from Provider Bulletin 2026-54 and the hospice rate changes from Provider Bulletin 2026-50 are reflected in the billing system for dates of service from that date forward, and that ICD-10 diagnosis and surgical codes added or discontinued on that date are updated in charge entry.
05Hospital billing staff: inpatient claims with a through date of service of Oct.
061, 2026 or later may suspend with EOB 0693 or 0920 until DSS loads the new 3M grouper, so check the suspended claim queue and watch for the Important Message that announces the load.
07By Nov.
0810, 2026 (tentative): Check the CMAP Addendum B Changes document on DSS's Hospital Modernization page for the October 2026 changes, and update the procedure code and status indicator set-up (G, K, K1, New and X) in charge entry before Nov.
0911, 2026, when DSS says new, changed and deleted procedure codes will be loaded.
10DSS and Gainwell are closed on Nov.
1111, 2026 and reopen on Nov.
1212, 2026, so plan claim submissions around that date.
13Hospitals with re-enrollment due dates (Saint Mary's Hospital inpatient on 12/17/2026; The Hospital of Central Connecticut on 1/6/2027 and 1/31/2027; The Danbury Hospital on 1/13/2027 and 2/24/2027; Lawrence and Memorial on 3/24/2027; William W.
14Backus on 3/26/2027) must submit re-enrollment applications early enough for DSS review, because dis-enrollment on the due date stops claims processing and eligibility checks until re-enrollment is complete.
15For claims denied with an EOB code, use Provider Manual Chapter 12 (Claim Resolution Guide) to correct and resubmit.

Original notice

DSS Important Message - Hospital Monthly Important Message - 10.19.2026
ctdssmap.com · Always check the source before changing claims.
View original ↗

Related policy hubs

Connecticut Medicaid (HUSKY Health) policiesCT policy changesPharmacyPathologyEndocrinologyGeneral Practice

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