MedicaidBilling CodesLow impact
Newsletter Vol. 35, No.11
New Jersey Medicaid·NJ · Psychiatry·Provider Notice
Effective date
Jul 1, 2025
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid will reimburse Opioid Treatment Programs (OTPs) for preparing and transporting methadone/buprenorphine to residential facilities using two new bundled HCPCS codes based on distance. The weekly bundles cover medication costs, preparation, and travel for up to 7 doses and cannot be billed concurrently with other OTP services.
Action Required
By July 1, 2025: OTPs providing MAT transport services must implement billing using HCPCS code S9381 with modifier U1 ($70.22) for distances under 50 miles and modifier U2 ($94.52) for distances 50+ miles. Update billing system to calculate distance from OTP to each residential facility individually. Bill through Fee-For-Service for ALL Medicaid members including MLTSS, FIDE-SNP, and DDD populations until managed care transition occurs.