Provider Updates

Important Reminder to our providers:

For all services or admissions that begin in 2011 and extend into 2012, you will need to split bill.

• For dates of service in 2011, please submit your claims to the appropriate MCO for HUSKY A, B and Charter Oak.
• For dates of service 1/1/12 and beyond, all claims are to be submitted to Hewlett Packard Enterprise Services, the department's medicaid management information system fiscal agent contractor.
• Additional billing information can be found on the Connecticut Medical Assistance Program website at www.ctdssmap.com

Important Provider Updates   (View DSS Provider Bulletins Here)

Effective April 1, 2013 patient panel report lists are now available on the secure provider portal. To access your reports, please login or register for an account using the button on the left.

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• New Prior Authorization Criteria for Proton Pump Inhibitors (PPIs) (May 24, 2013)
• Important Connecticut Home Care Online Enrollment Notification, Claim Submission and Other Program Changes (May 20, 2013)
• Electronic Claims Submission, Web Remittance Advice, Check, EFT and 835 Schedule (May 20, 2013)
• Implementation of Affordable Care Act Claim Edits (May 15, 2013)
• Psychotherapy Prior Authorization Changes (May 13, 2013)
• Clarification: Updated MEDS Fee Schedule and Reimbursement (April 26, 2013)
• Children’s Behavioral Health Rehabilitation Billing Procedures (April 26, 2013)
• Change in Professional Fee (Dispensing Fee) (April 26, 2013)
• Change in Methodology for Measurement of Access Standard (April 16, 2013)
• Important CHC Provider Enrollment and Claim Submission Changes (April 16, 2013)
• Prior Authorization Requirements – Independent Chiropractic Services (April 11, 2013)
• Transition to the Updated ADA 2012 J434 Dental Claim Form (April 11, 2013)
• Requirements for Payment of Services Provided by Physicians (April 11, 2013)
• Procedure Codes Excluded from Applied Income (April 11, 2013)
• Updated Medical Transportation Fee Schedule (March 25, 2013)
• Transportation Billing Update (March 25, 2013)
• RCC Crosswalk to New Psychiatric Procedure Codes for 2013 (March 20, 2013)
• Non-Emergency Ambulance Coverage For HUSKY B and Charter Oak Clients (March 20, 2013)
• Electronic Funds Transfer Change Notification (March 20, 2013)
• Public Act 12-1 Reporting Requirements (February 6, 2013)
• Elimination of Paper Re-enrollment Applications (February 5, 2013)
• Updated MEDS Fee Schedule and Reimbursement (February 5, 2013)
• Elimination of Independent Chiropractic Services (February 5, 2013)
• Connecticut Medicaid Electronic Health Record (EHR) Incentive Program – Financial incentives for electronic health record adoption and meaningful use. (January 30, 2013)
• Enhanced Payments for Primary Care Services (January 30, 2013)
• National Correct Coding Initiative (NCCI) Edit (January 30, 2013)
• Updated Medical Transportation Fee Schedule (January 18, 2013)
• Change in Hospice Rates (January 18, 2013)
• School Based Child Health Service Providers Re-enrollment process in the Connecticut Medical Assistance Program (January 10, 2013)
• State Funded Home Care Program for Elders (January 10, 2013)
• Behavioral Health Clinician Fee Schedule Update (January 10, 2013)

Incorporation of January 2013 Healthcare Common Procedure Coding System (HCPCS):

• Incorporation of January 2013 HCPCS (January 10, 2013)
• Incorporation of January 2013 HCPCS 2 (January 10, 2013)
• Incorporation of January 2013 HCPCS 3 (January 10, 2013)
• Incorporation of January 2013 HCPCS 4 (January 10, 2013)

  Additional Modifiers, Psychotherapy Changes for 2013 and ACA Increased Payments for Medicaid Primary Care Services

• Incorporation of January 2013 HCPCS 5 (January 10, 2013)
• Change in Professional Fee (Dispensing Fee) (January 4, 2013)
• Changes to the Connecticut Medicaid Preferred Drug List (PDL) (January 4, 2013)
• Medicare D Coverage of Benzodiazepines and Barbiturates (December 20, 2012)
• Consolidated Laboratory Fee Schedule Update (December 18, 2012)
• Certificate of Need Requirement for Inpatient Admissions for Individuals Under the Age of 21 (December 13, 2012)
• Performing Provider Enrollment Requirements for Nursing Homes, Home Health, Radiology and State Agencies in the Medicaid Program (December 7, 2012)
• Florida Prescriber’s DEA License Suspension (December 7, 2012)
• MEDS - Fee Schedule Changes for HCPCS E0445, E0770 and S1040 (December 7, 2012)
• State Funded Coverage for Chiropractic Services (November 20, 2012)
• Expansion of Medicaid Prescription Vouchers for Individuals Released from Correctional Institutions or Through the Courts (November 1, 2012)
• Enhanced Care Clinic Access Requirements Clarification (October 23, 2012)
• CT BHP Extended Day Treatment (EDT) Reimbursement Rate Increase for HUSKY Members (October 23, 2012)
• Enhanced Care Clinic Surveys (October 23, 2012)
• Drug and Alcohol Abuse Center Fee Schedule Update (October 22, 2012)
• Important Changes to Provider Enrollment (October 22, 2012)
• Important Changes to Provider Re-enrollment (October 22, 2012)
• Fee Schedule Update for Behavioral Health Services (October 22, 2012)
• Availability of Pharmacy Prior Authorization (PA) Forms (October 19, 2012)
• Requirements for Payment to Birth Centers (October 19, 2012)
• Physician Fee Schedule – Reimbursement Updates for Obstetrical Delivery Procedures Codes (October 11, 2012)
• Change of Dental Fee Payment for Dentures and Resin Fillings (October 11, 2012)
• Private Non-Medical Institution (PNMI) Rates for Adult Mental Health Rehabilitation Services (October 5, 2012)
• Change of Dental Benefit Assignment by Dental Provider to Benefit Assignment by Client (October 3, 2012)
• National Correct Coding Initiative (NCCI) New Medicaid-Only Procedure to Procedure (PTP) Edits Relating to Wheelchairs (October 3, 2012)
• Client Notification Regarding the Use of A One-Time, 14-day Prior Authorization (October 3, 2012)
• Expansion of the NCPDP Response Segment to Support NCPDP D.0 Reject Codes (October 3, 2012)
• New Medicaid (HUSKY) Spend-down Procedures (Semptember 21, 2012)
• Diabetes Review and Update Training Brochure (Semptember 18, 2012)
• Open Forum on Adopt/Implement/Upgrade (AIU) Attestation (Semptember 12, 2012)
• Open Forum on Meaningful Use (Semptember 12, 2012)
• Provider Data Verification Online Survey available starting August 20, 2012 (August 15, 2012)
• Ophthalmologists, Optometrists, Opticians, and Dental Providers Web Portal Claim History Inquiry (August 14, 2012)
• Meaningful Use Attestation Available for Connecticut Medicaid EHR Incentive Program (July 27, 2012)
• New Personal Care Agency (PCA) Per Diem and PCA Overnight Procedure Codes (July 20, 2012)
• Changes to Prior Authorization Process for Outpatient Surgery (July 2, 2012)
• Hospital Inpatient Services (June 26, 2012)
• Changes to the Connecticut Medicaid Preferred Drug List (PDL), Reminder About the 5 day Emergency Supply, Billing Clarification for Brand Name Medications on the Preferred Drug List (PDL) and New MAC Pricing Inquiry Worksheet (June 19, 2012)
• Change in Procedures for Brand Medically Necessary Pharmacy Prior Authorizations (June 14, 2012)
• Consolidated Laboratory Fee Schedule Update (June 8, 2012)
• Changes to Prior Authorization Process for Laboratory Procedures and Outpatient Surgery (June 5, 2012)
• Authorization Portal for Requesting MEDS (June 5, 2012)
• Changes to Authorization Process and New Authorization Portal for Requesting Rehabilitation Therapy (June 5, 2012)
• Payment Error Rate Measurement (PERM) Program Audit Requests (May 16, 2012)
• Changes to Request Process for Vision Care that Require Prior Authorization (May 11, 2012)
• Physician Signature on the CMS-485, Home Health Certification and Plan of Care (May 2, 2012)
• Update Concerning Prior Authorization (PA) Requests for Repairs to Prosthetics (May 1, 2012)
• Authorization Portal for Medical Admissions (April 17, 2012)
• Important Changes to Radiology Services (April 11, 2012)
• Other Provider Preventable Conditions (OPPCs) Reporting Requirements (April 11, 2012)
• Physician Fee Schedule Updates: Updated fees for Psychiatric and Selected Adult Medical Services (April 5, 2012)
• Behavioral Health Clinician Coverage for Individuals Under Age 21 in Fee-For-Service Medicaid (HUSKY C) and Medicaid for Low Income Adults (HUSKY D) (April 5, 2012)
• Behavioral Health Clinician Fee Schedule Update (April 5, 2012)
• Clarification of Billing Requirements for Medications Covered by Medicare Part D and Medicare Part B Including Additional Third Party Insurance (April 5, 2012)
• Authorization Portal for Requesting Medical Home Care Services (Mar. 28, 2012)
• Authorization Portal for Requesting Outpatient Hospital Rehabilitation Therapy (Mar. 28, 2012)
• Transition from Revenue Center Code 513 to More Precise Coding for Hospital Outpatient Psychiatric Services (Mar. 28, 2012)
• Enhanced Editing of Prescribing Provider NPI Numbers (Mar. 20, 2012)
• New Family Planning Coverage Group: Family Planning Services - Limited Benefit (Mar. 8, 2012)
• Consolidated Laboratory Fee Schedule Update (Mar. 8, 2012)
• New Physician Specialties for the Connecticut Medical Assistance Program (Mar. 8, 2012)
• Updated MEDS Fee Schedule and Reimbursement (Mar. 8, 2012)
• Independent Radiology Fee Schedule: 2012 Healthcare Common Procedure Coding System (HCPCS) Changes (Mar. 8, 2012)
• Presumptive Eligibility Certification and Guarantee of Payment Form, W-538 (Mar. 8, 2012)
• Direct Billing of Clients for Medicaid Covered Addiction Services and Billing for Addiction-Related Laboratory Services (Feb. 7, 2012)
• Instructions for Mass Load of Performing Providers (Feb. 7, 2012)
• Provider Enrollment Requirements for Hospitals and Clinics in the Medicaid Program (Nov. 30, 2011)
• Global Billing of Obstetric Care (Nov. 14, 2011)
• Changes Regarding the New HUSKY Health Program (Oct. 10, 2011)
• DSS Announces the New HUSKY Health Program (October 2011)