MedicaidCoverageLow impact
Newsletter Vol. 34, No.07
New Jersey Medicaid·NJ · OB-GYN, Family Medicine, Internal Medicine·Medical Policy
Effective date
Jul 1, 2024
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid/FamilyCare will now reimburse pharmacies an additional $20.60 administration fee for providing education and consultation when dispensing hormonal contraceptives under a standing order (without individual prescriptions). Pharmacies must use specific billing codes and the standing order NPI to receive this additional reimbursement.
Action Required
By July 1, 2024: This policy affects pharmacies only, not medical practices. Medical billing teams should be aware that patients may now obtain hormonal contraceptives directly from pharmacies without requiring a prescription from your practice, potentially reducing contraceptive prescription volume.