MedicaidAdministrativeHigh impact
Newsletter Vol. 34, No.13
New Jersey Medicaid·NJ · Psychiatry·Eligibility
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
New Jersey is transferring behavioral health services from Fee-for-Service to Managed Care Organizations (MCOs) starting January 1, 2025. Providers must contract and credential with MCOs by this date to continue billing for outpatient mental health and substance use disorder services.
Action Required
By January 1, 2025: Behavioral health providers must complete contracting and credentialing with all five NJ MCOs (Aetna, Fidelis Care, Horizon, United Healthcare, Wellpoint) to continue providing Phase 1 services. Contact each MCO's network relations department immediately to initiate the process. If credentialing cannot be completed by the deadline, establish single case/out-of-network agreements with MCOs to ensure continuity of care and payment. Failure to complete this process will result in service and reimbursement disruptions.