MedicaidAdministrativeMedium impact
Newsletter Vol. 35, No.09
New Jersey Medicaid·NJ·Medical Policy
Effective date
Jun 1, 2024
We identified it
Jun 20, 2026
Summary
NJ FamilyCare now allows Physician Assistants (PAs) to enroll as rendering providers on professional claims, effective June 1, 2024. PAs will receive individual 7-digit Medicaid IDs and must be listed as the rendering provider on claims for services they provide, while the physician/group/clinic remains the billing provider. PAs are now searchable in the NJ FamilyCare Provider Directory and MCO directories.
Action Required
REQUIREMENTS:
- By December 31, 2024: Billing team must verify that all PAs employed by the practice are enrolled as rendering providers in NJ FamilyCare. Contact Gainwell Technologies Provider Enrollment Unit at 609-588-6036 to initiate PA enrollment using either the 'Group Practice Application' (for new groups) or 'Add Application' (for existing practices) at www.NJMMIS.com.
- Immediately: Update billing software and claims submission procedures to require the PA's National Provider Identifier (NPI) and 7-digit Medicaid ID as the rendering provider on all professional claims where the PA provided the service. The physician/group/clinic NPI must remain as the billing provider.
- Before January 1, 2025: Ensure all encounter forms, charge tickets, and EMR templates capture which PA rendered the service. Verify that each PA's specialty matches one of the group's reported specialties on the enrollment application.
- Ongoing: When submitting claims for PA-rendered services, report the PA's NPI as the rendering provider and the physician group/clinic as the billing provider. Failure to properly identify PAs as rendering providers may result in claim processing delays or denials and will prevent PAs from appearing in provider directories.