MedicaidCoverageMedium impact
Medicaid Alert MA-2025-04
New Jersey Medicaid·NJ · Hematology, Oncology·Coding
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid has established a Cell and Gene Therapy (CGT) Access Model with specific billing guidance for Sickle Cell Disease gene therapy treatments. This creates new billing procedures and requirements for providers treating SCD patients with gene therapy.
Action Required
Immediately: Billing team should review the full policy document at https://www.njmmis.com/documentDownload.aspx?document=MA-2025-04.pdf to understand new CGT Access Model requirements. Update billing procedures for any sickle cell disease gene therapy treatments according to the new guidance. Providers treating SCD patients should familiarize themselves with the new model requirements.