Connecticut Billing Guide for Mental Health Therapists and Psychiatrists
Who pays, where to enroll and which rules change your claims in Connecticut, for psychotherapists and psychiatric prescribers.
Last checked October 25, 2026. Reviewed against the official sources listed at the bottom of this page.
This Connecticut billing guide covers Medicaid, Medicare, Blue Cross, other private payers and state law for therapists and psychiatrists, with sources and a last-checked date.
Connecticut billing guide: how Connecticut pays for outpatient care
Connecticut Medicaid, branded HUSKY Health, is run by the Department of Social Services (DSS) on a fee-for-service basis. Behavioral health is managed by Carelon Behavioral Health, the administrative services organization (ASO) for the Connecticut Behavioral Health Partnership (CT BHP), which DSS runs jointly with the Department of Children and Families (DCF) and the Department of Mental Health and Addiction Services (DMHAS).
Commercial behavioral health coverage is regulated by the Connecticut Insurance Department, which announced parity enforcement actions against five carriers on April 22, 2026. Medicare Part B claims go to National Government Services (NGS), now operating as Wellpoint Federal, in Jurisdiction K.
Who to bill, at a glance
| Payer type | Who you bill | Where to enroll or check rules |
|---|---|---|
| Medicaid | HUSKY Health, run by the Department of Social Services; behavioral health through Carelon (CT BHP) | DSS HUSKY information |
| Medicare Part B | National Government Services (NGS), operating as Wellpoint Federal, Jurisdiction K | CMS MAC page |
| Blue Cross Blue Shield | Anthem Blue Cross and Blue Shield (Connecticut) | See the Blue Cross section below |
Connecticut Medicaid: HUSKY Health
This Connecticut billing guide starts with Medicaid, because it decides who pays and how you file.
Connecticut Medicaid pays providers fee-for-service rather than through risk-bearing managed care organizations (MCOs). Carelon administers behavioral health benefits for HUSKY A, B, C and D and the DCF Limited Benefit Program: utilization management, care management and the credentialed provider network.
Clinical authorizations go through the Carelon provider portal. Medical prior authorization is handled separately by the medical ASO. Check the Carelon quick reference guide for the current process.
| Item | What to know |
|---|---|
| Agency | Connecticut Department of Social Services (DSS) |
| Behavioral health administrator | Carelon Behavioral Health, ASO for the CT BHP |
| Work requirement | HUSKY D work rules and six-month renewals start January 1, 2027 under H.R. 1. Adults 19 to 64 not living with a child under 14 need $580 or more per month in earnings, or 80 hours per month of work, community service or training, or half-time school. The DSS FAQ lists adults with serious mental illness or chronic substance use disorders and people in drug or alcohol treatment as exempt. |
Medicare Part B in Connecticut
For Medicare, this Connecticut billing guide names your contractor and the current telehealth rules.
Medicare Part B pays for outpatient psychotherapy and psychiatric visits billed to the Medicare Administrative Contractor (MAC) for your state. CMS's July 14, 2026 fact sheet on the CY2027 Physician Fee Schedule proposed rule says the Consolidated Appropriations Act, 2026 extended telehealth payment authority through December 31, 2027, and proposes that in-person visit requirements for mental health visits not apply to services furnished through that date.
| Item | What to know |
|---|---|
| Contractor | National Government Services (NGS), operating as Wellpoint Federal |
| Jurisdiction | Jurisdiction K: CT, ME, MA, NH, NY, RI and VT |
| Source | CMS.gov MAC page |
Blue Cross Blue Shield in Connecticut
This part of the Connecticut billing guide names the exact Blue Cross licensee, because Blue plans never share rules.
Blue Cross Blue Shield is a federation of independent companies, so one licensee's rules never apply to another. In Connecticut that is Anthem Blue Cross and Blue Shield. Anthem Connecticut Provider News set a 90-day professional claim filing limit effective October 1, 2019; confirm the current limit in the Anthem Connecticut provider manual before you rely on it.
| Licensee | Parent or affiliation | Where it applies | Provider resources |
|---|---|---|---|
| Anthem Blue Cross and Blue Shield (Connecticut) | Anthem brand; see our Connecticut Blue Cross guide | Connecticut | Anthem Connecticut provider news |
Other private payers and EAPs in Connecticut
The Connecticut billing guide also covers commercial plans and employee assistance programs.
These commercial payers and plan families most often matter for behavioral health billing in Connecticut. Check each payer's current provider manual before you submit.
| Payer | Behavioral health note | Provider resources |
|---|---|---|
| Carelon Behavioral Health (Anthem Connecticut) | Behavioral health reference materials for Anthem Connecticut commercial and Medicare Advantage plans. Claims go through Availity, and credentialing follows the Carelon provider handbook. | Official page |
| Aetna, Anthem, ConnectiCare, Cigna and UnitedHealthcare | Named in the Connecticut Insurance Department's April 22, 2026 parity (NQTL) report release as subject to enforcement actions. | Official page |
Connecticut billing guide: state law that changes billing
Use this section of the Connecticut billing guide to separate state law from payer policy.
State law sets the floor for commercial plans in Connecticut. Medicare and Medicaid rules are covered in their own sections above.
Mental health parity
Connecticut strengthened its mental health parity requirements in 2025 (S.B. 10). Carriers file annual parity compliance reports with the Connecticut Insurance Department (CGS 38a-477ee), which announced enforcement actions against Aetna, Anthem, ConnectiCare, Cigna and UnitedHealthcare on April 22, 2026. Source
Telehealth coverage and payment parity
Private payers must cover telehealth when the same service is covered in person (CGS 38a-499a and 38a-526a). Under PA 24-110, carriers cannot reduce payment to a telehealth provider solely because care was delivered by telehealth. HUSKY covers live video and audio-only (CGS 17b-245e and 17b-245g). Source
Practitioner scope: therapists and prescribers
Providers need an active Connecticut license to treat Connecticut patients by telehealth. HUSKY behavioral health eligible providers include physicians, PAs, APRNs, licensed psychologists, clinical social workers, marital and family therapists, professional counselors and alcohol and drug counselors. Source
Not legal advice. Confirm statute details with counsel.
Connecticut billing guide: codes and rates
This Connecticut billing guide lists only codes and rates confirmed on official pages.
These are the Connecticut-specific codes, modifiers and rate items confirmed on official pages. Medicare's own CY2027 conversion factor proposal is listed under What changed.
| Code or item | What to know |
|---|---|
| 98012 and 98013 (audio-only E/M visits) | HUSKY covers audio-only medical and medication management visits with these codes from 1/1/2025. Source |
| Modifiers GT or 95 (video) and FQ (audio-only behavioral health) | HUSKY telehealth modifiers. Source |
| 90853 group psychotherapy | Under HUSKY, group psychotherapy by telehealth must be synchronous audio-visual. Source |
| Collaborative Care Model (CoCM) | Covered for HUSKY A through D from 7/1/2026. Source |
Connecticut billing guide: what changed, newest first
Check this Connecticut billing guide update log before you rely on an older rule.
| Date | What changed | Source |
|---|---|---|
| 2027-01-01 | HUSKY D work requirements and six-month renewals begin under H.R. 1. | Source |
| 2026-07-14 | CMS released the CY2027 Medicare Physician Fee Schedule proposed rule: conversion factor $32.84 for non-qualifying APM participants (down 1.68%) and $33.17 for qualifying participants (down 1.19%). | Source |
| 2026-07-01 | HUSKY began covering the Collaborative Care Model for HUSKY A through D and allowed telehealth initial evaluations at Enhanced Care Clinics (Provider Bulletin 2026-37). | Source |
| 2026-04-22 | Connecticut Insurance Department released its 2026 NQTL annual report and announced enforcement actions against five carriers. | Source |
| 2026-04-01 | National Government Services began operating as Wellpoint Federal. | Source |
How do I bill mental health claims in Connecticut?
These answers come from the same sources as the rest of this Connecticut billing guide.
Start with the member's payer type. HUSKY Health (Medicaid) pays fee-for-service, with behavioral health authorizations and network credentialing handled by Carelon. Medicare Part B goes to NGS in Jurisdiction K. Commercial claims go to the member's plan, and Anthem is the Blue Cross Blue Shield licensee for Connecticut.
Questions about billing in Connecticut
Who manages behavioral health for Connecticut Medicaid (HUSKY)?
Carelon Behavioral Health is the administrative services organization for the Connecticut Behavioral Health Partnership, managed jointly by DCF, DSS and DMHAS. It handles utilization management, care management and a credentialed provider network for HUSKY A, B, C and D members.
When do HUSKY D work requirements start?
January 1, 2027. Adults 19 to 64 without a child under 14 must show $580 or more in monthly earnings, 80 hours of work, service or training, or half-time school, with exemptions such as serious mental illness and treatment participation. Renewals move to every six months.
Does Connecticut require payment parity for telehealth with commercial insurers?
Under PA 24-110, carriers cannot reduce payment to a telehealth provider solely because care was delivered by telehealth, and telehealth must be covered if the same service is covered in person, per the Center for Connected Health Policy summary.
What did Connecticut announce about mental health parity enforcement in 2026?
On April 22, 2026 the Connecticut Insurance Department released its NQTL annual report and announced enforcement actions against Aetna, Anthem, ConnectiCare, Cigna and UnitedHealthcare.
Does MCM South bill for practices in Connecticut?
MCM South serves Connecticut. Request a quote to talk through your practice.
Sources for the Connecticut billing guide
Last checked October 25, 2026. Every source below was opened and read on that date.
- CT DSS H.R. 1 member FAQ, checked October 25, 2026
- CT Hospital Association: HUSKY D work rules update, checked October 25, 2026
- Carelon Connecticut provider quick reference guide, checked October 25, 2026
- Carelon Connecticut provider handbook addendum, checked October 25, 2026
- Center for Connected Health Policy: Connecticut, checked October 25, 2026
- Connecticut Insurance Department, April 22, 2026 release, checked October 25, 2026
- Anthem Connecticut provider news: timely filing, checked October 25, 2026
- CMS: CY2027 Physician Fee Schedule proposed rule fact sheet, checked October 25, 2026
- CMS MAC jurisdiction page, checked October 25, 2026
Related guides
- State & Regional Billing Guides hub
- Connecticut insurance companies contact guide
- In-network vs out-of-network credentialing
- Credentialing and network status
- Blue Cross Blue Shield guide for Connecticut
- Connecticut Medicaid billing codes
- Mental health parity explained
- Medicaid managed care billing
- Medicare behavioral health billing
- Timely filing in the billing glossary
- Who we serve
- Massachusetts insurance companies contact guide
Billing in Connecticut? Let us handle the payer calls.
MCM South bills only mental and behavioral health, for psychotherapists and psychiatrists, in solo and medium-size practices. We serve Connecticut.
MCM South currently serves practices in ten states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois.