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Newsletter Vol. 36, No.03

New Jersey Medicaid·NJ · Palliative Care, Family Medicine, Internal Medicine·Medical Policy
Effective date
Apr 1, 2026
We identified it
Jun 20, 2026
Days to comply

Summary

New Jersey Medicaid is launching a Community-Based Palliative Care (CBPC) benefit effective April 1, 2026. Eligible providers (hospice, home health, physician groups, independent clinics) can enroll starting February 2, 2026, with specific credentialing requirements and new HCPCS billing codes for assessments and monthly bundled payments.

Action Required

Action needed
By February 2, 2026: Eligible providers (hospice, home health, physician groups, independent clinics) must complete NJMMIS enrollment using Form FD-439 for CBPC services. Ensure IDT includes required credentials (MD/DO, NP/PA, RN, LCSW/LPC/LMFT, Chaplain). By April 1, 2026: Update billing system with new HCPCS codes S0280 (initial assessment), S0281 (reassessment), S0311 (monthly PMPM). Complete MCO credentialing and contracting for covered members. Claims without proper enrollment and credentialing will be denied.

Affected Billing Codes

S0280
S0281
S0311