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H1N1 News

1. A specific CPT code for the H1N1 vaccine has been established.  That code is 90663 and is applicable whether the vaccine is either intranasal or injectable.
2. CPT 90663 is NOT reimbursable and there is no age limitation for this vaccine.
3. A new code, CPT 90470 - H1N1 immunization administration (intramuscular, intranasal), including counseling when performed, has been established for administration of the H1N1 vaccine.  CPT 90470 should be reimbursed $12.52.
4. The E&M code for office visit is 99211 or 99212, depending on the professional level of "vaccinator".

** NOTICE TO CT HOSPITALS **

Your FFY08 Medicaid FFS Inpatient rate notification indicated DSS was seeking the assistance of CHA in "developing an appropriate method of processing payment differentials for services initially paid for by [Medicaid] managed care companies during the current state fiscal year." DSS expects to directly remit any payment differentials for hospital inpatient services delivered to Medicaid managed care members.

Until such time as DSS finalizes it decision directing Medicaid managed care plans on how to proceed with potential retro-active rate implementation, CHNCT is not preparing to unilaterally address this matter.

For CHNCT Husky A & B members, under the Husky ASO Program it is expected recently announced Medicaid FFS inpatient interim per diem rates will be utilized to pay inpatient claims with service dates on/after January 1, 2008. DSS is expected to address this matter directly with Husky ASO insurers prior to the end of next week.

Out-of-Network Provider Process

Please see below for our Provider Newsletters. In order to view them, you will need to have a version of the free Adobe Acrobat Reader (version 4.0 or greater) installed on your computer. If you do not have a copy of this software and would like to download it, please click here to obtain it. To view a Provider Newsletter, please click on one of the below links to view the newsletter for that specific month.

Provider Newsletters and Communications