SPA 26-Z July 2026 HIPAA Updates for Physician Services, Updates to Skin Substitutes and Chiropractic Services, and Updates to the Reimbursement Rates for Select Procedure Codes for Radiology Services and Optometry Services
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This State Plan Amendment updates Connecticut Medicaid reimbursement for physician office and outpatient services, skin substitutes, chiropractic services, radiology services, and optometry services. It affects Medicaid providers using the applicable Connecticut fee schedules.
The physician office and outpatient fee schedules incorporate applicable HCPCS additions, deletions, and description changes.
Several skin substitute procedure codes identified as investigational or not FDA-approved are end-dated.
Reimbursement for several FDA-approved skin substitute procedure codes is repriced.
Chiropractic procedure code 98943 is end-dated.
Reimbursement rates for selected radiology services are updated on the physician radiology and independent radiology fee schedules.
Selected optometry procedure codes increase from 90% of physician rates to 100% of physician rates.
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