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MedicaidReimbursementHigh impact

Medicaid Alert MA-2023-05

New Jersey Medicaid·NJ · Psychiatry, Family Medicine, Pediatrics·Reimbursement
Effective date
Jul 1, 2023
We identified it
Jun 20, 2026
Days to comply

Summary

New Jersey Medicaid has increased reimbursement rates for behavioral health services effective July 1, 2023. The policy provides updated payment rates for psychiatric evaluations, psychotherapy, medication monitoring, and substance abuse treatment services with different rates for specialists vs non-specialists and child-specific services.

Action Required

Action needed
Immediately: Billing team must update fee schedules in billing system with new Medicaid reimbursement rates for all listed behavioral health CPT codes and HCPCS codes effective July 1, 2023. Ensure system differentiates between specialist/non-specialist rates and child-specific rates. Update encounter forms and verify all claims with dates of service on or after July 1, 2023 use the new rates. Monitor www.njmmis.com for future rate updates.

Affected Billing Codes

90791
90792
90832
90833
90834
90836
90838
90847
90853
90887
99202
99203
99204
99205
99211
99212
99213
99214
99215
G2067
G2068
G2074
G2078
G2079
H0003
H0010
H0014
H0015
H0018