MedicaidCoverageMedium impact
Medicaid Alert MA-2025-03
New Jersey Medicaid·NJ · Dentistry, Oral & Maxillofacial Surgery·Eligibility
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid (NJ FamilyCare) will now provide outpatient hospital reimbursement for dental services specifically for fee-for-service beneficiaries who have chronic medical conditions and/or developmental disabilities resulting in special healthcare needs. This expands coverage for dental services in hospital outpatient settings for this specific patient population.
Action Required
Immediately: Billing teams should review patient eligibility criteria to identify NJ FamilyCare FFS beneficiaries with chronic medical conditions or developmental disabilities who may now qualify for outpatient hospital dental service coverage. Update billing workflows to capture this expanded coverage opportunity and ensure proper claim submission for eligible patients.