MedicaidCoverageLow impact
Newsletter Vol. 35, No.12
New Jersey Medicaid·NJ · Pediatrics, Family Medicine, Allergy & Immunology +1 more·Medical Policy
Effective date
Dec 5, 2025
We identified it
Jun 20, 2026
Summary
NJ FamilyCare continues coverage for Hepatitis B vaccination for all members ages 0-18 years, aligning with American Academy of Pediatrics (AAP) guidelines and the December 5, 2025 NJ Department of Health Executive Directive No. 25-005. Coverage includes doses administered within 24 hours of birth and requires no additional medical necessity documentation. Billing follows current procedures through both fee-for-service and managed care delivery systems.
Action Required
Immediately: Billing and clinical staff should verify that current Hepatitis B vaccination billing procedures remain unchanged and continue to reference the current AAP Immunization Schedule (https://downloads.aap.org/AAP/PDF/AAP-Immunization-Schedule.pdf) for dosing and scheduling guidance. No billing system updates are required. Ensure providers document that Hepatitis B vaccines administered to eligible NJ FamilyCare members ages 0-18 are covered without requiring prior authorization or additional medical necessity documentation. Managed care organizations must ensure member communications accurately reflect this policy.