MedicaidReimbursementHigh impact
Newsletter Vol. 35, No.08
New Jersey Medicaid·NJ · Family Medicine, Internal Medicine, General Practice +2 more·Reimbursement
Effective date
Jul 1, 2025
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid is increasing reimbursement rates for primary care services to 70% of Medicare rates, effective July 1, 2025. This applies to evaluation and management codes (99202-99499) and immunization administration codes, with managed care organizations required to use these as minimum payment rates.
Action Required
By July 1, 2025: Billing team must verify that New Jersey Medicaid claims for primary care evaluation and management codes (99202-99499) and immunization administration codes (90465-90480) are being reimbursed at the new minimum rate of 70% of Medicare rates. Review managed care contracts to ensure compliance with new minimum payment requirements. Contact Gainwell Technologies at 1-800-776-6334 for questions about implementation.