Medicaid CT – 2022 Revision of Rates for Certain Clinical Diagnostic Laboratory Testing Codes

Effective for dates of service retroactive to January 1, 2022, and forward, the Connecticut Medical Assistance Program (CMAP) Department of Social Services (DSS) is adjusting the reimbursement for certain clinical diagnostic laboratory services. 

This update is being made to comply with federal Medicaid law (42 U.S.C. § 1396b(i)(7)), which prohibits state Medicaid programs from paying more than Medicare would pay for any laboratory service. 

These changes apply to the HUSKY Health Programs A, B, C and D. 

The following update is being made for dates of service January 1, 2022, and forward: 

Please note: Claims billed with dates of service January 1, 2022, and forward will be automatically reprocessed and reimbursed up to the billed amount or new reimbursement rate, whichever is lower, in the March 18, 2022, claim cycle, which you will see on your March 23, 2022 Remittance Advice.