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MedicaidBilling CodesHigh impact

Medicaid Alert MA-2025-01

New Jersey Medicaid·NJ · Psychiatry·Coding
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

New Jersey Medicaid now allows FQHCs to bill for services provided by Licensed Professional Counselors (LPCs) and Licensed Marriage and Family Therapists (LMFTs). Psychotherapy services must be billed with HEHH modifier and substance use counseling with HFHH modifier, along with specific encounter codes.

Action Required

Action needed
Immediately: FQHCs must enroll LPCs and LMFTs through www.njmmis.com enrollment process before billing for their services. Update billing system to use HEHH modifier for psychotherapy services (90832HEHH, 90834HEHH) with T1015HE encounter code, and HFHH modifier for substance use counseling (90837HFHH, 90853HFHH) with G0470HQ encounter code. Cannot bill for services provided before provider enrollment date.

Affected Billing Codes

90832
90834
90837
90853
T1015
G0470