Credentialing in Connecticut

Behavioral health runs through the Connecticut Behavioral Health Partnership: "DCF, DMHAS, and DSS are member partners of the CT BHP, and jointly contract with and manage Carelon Behavioral Health as the Administrative Services Organization (ASO)". Carelon (ex-Beacon) has held the ASO role "since the program's inception in 2006."

CGA BHPOC, CT BHP Overview 2026 deck (2026-02-18) · checked Jul 2026

Connecticut Medicaid is HUSKY Health (HUSKY A/C/D = Medicaid; HUSKY B = CHIP), administered by the Department of Social Services (DSS). Providers enroll in the Connecticut Medical Assistance Program (CMAP) through www.ctdssmap.com, "provided by Gainwell Technologies on behalf of the Connecticut Department of Social Services." Multi-factor authentication becomes mandatory on the portal 2026-08-01.

ctdssmap.com, Connecticut Medical Assistance Program portal · checked Jul 2026

Connecticut is nationally unique: there are NO capitated Medicaid MCOs, no MCO panels, no plan contracting, no per-plan credentialing. The state self-insures and pays fee-for-service off the DSS fee schedule, with CHNCT (Community Health Network of Connecticut) as "the State of Connecticut's Medical Administrative Services Organization (ASO) for the HUSKY Health program." CMAP enrollment approval IS full network entry, claims go to Gainwell, not to plans.

HUSKY Health provider site (CHNCT) · checked Jul 2026

Associate licensed clinicians (LMSW, LMFT-Associate, LPC-Associate) cannot enroll in CMAP. Instead, per DSS Provider Bulletin 2022-67 (effective DOS 2022-10-01): "When the claim is billed, the supervising provider must be entered as the billing provider if the services was rendered in an individual practice or as the performing provider if rendered in a group practice," reimbursed "at the same rate as if the service was rendered by the independent licensed supervising clinician." Requires weekly direct supervision, with documentation co-signed by the supervisor at least weekly.

CT DSS Provider Bulletin 2022-67 · checked Jul 2026

All Connecticut BH licenses issue from the Department of Public Health (DPH), no standalone boards: LPC / LPCA (CGS ch. 383c; associate tier added by PA 19-117), LMFT / marital-and-family-therapy associate (ch. 383a; associate licenses issued on/after 2023-07-01 run 12 months, renewable up to 3 times), and LCSW / LMSW (ch. 383b).

Connecticut General Statutes ch. 383c (CGA) · checked Jul 2026

Connecticut is on the Counseling Compact jurisdictions list (passed the Compact language) but NOT issuing privileges as of July 2026 (issuers: AZ, MN, OH, LA, GA, IN).

Counseling Compact, Compact Jurisdictions list · checked Jul 2026

The PB 2022-67 associate lane is the only sanctioned carve-out: a group claiming services "provided by a 'licensed eligible' individual, intern, by utilizing the NPI of an enrolled licensed behavioral health clinician" is DSS's textbook improper-claim example, subject to recoupment.

Gainwell/DSS, BHC Training deck (04/10/2023) · checked Jul 2026

Outpatient BH clinicians enroll as provider type 33, Behavioral Health Clinicians: "All licensed behavioral health clinicians: LCSW, LADC, LMFT, LPC, and Ph.D. and Psy.D." Every BH clinician group and solo clinician must e-sign the Gainwell attestation (PB 2023-14); a missing or invalid attestation denies claims with EOB codes 1043/1046/1047/1059.

Gainwell/DSS, BH Clinician Groups and Individual Clinicians in Independent Practice FAQ (07/26/2023) · checked Jul 2026

The DSS Medicaid Landscape Analysis Final Report (Dec 2024) recommends, verbatim, "DSS should explore targeted areas to reduce costs and improve outcomes instead of pursuing a transition to comprehensive managed care at this time." Connecticut Medicaid admin runs 3.8% vs ~9.4% managed-care-state average, and a transition would add ~$240M/yr in non-federal admin spend. The ASO/no-MCO model is affirmatively re-endorsed.

CT DSS, Medicaid Landscape Analysis Final Report (Dec 2024) · checked Jul 2026

Authorization routing splits by service, not payer: detox/withdrawal admissions and BH-unit transfers "must be submitted to CT BHP for prior authorization," while medical admissions and ICU go to CHNCT.

CHNCT provider prior-authorization FAQ · checked Jul 2026