MedicaidBilling CodesMedium impact
2025.79 - New J Code for Billing Spravato - Spravato Coverage Guidelines
Connecticut Medicaid (HUSKY Health)·CT · Psychiatry·Provider Bulletin
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (HUSKY) is implementing a new J-code (J0013) for billing Spravato (esketamine nasal spray) effective January 1, 2026, replacing the previous S0013 code. The policy updates prior authorization requirements and clarifies billing procedures for both physician offices and outpatient hospitals administering this treatment for depression.
Action Required
By January 1, 2026: Billing team must update system to use new code J0013 for Spravato (esketamine nasal spray) instead of S0013 for Connecticut Medicaid patients. Stop using unclassified drug code J3490 for Spravato. Outpatient hospitals should use G2082 (up to 56mg) or G2083 (greater than 56mg) with revenue code 919. Ensure prior authorization is obtained using Connecticut-specific PA forms before administration. Update encounter forms to reflect new codes.