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MedicaidAdministrativeMedium impact

Medicaid Alert MA-2023-04

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

Summary

Medicaid pharmacy billing accommodations that were implemented during the COVID-19 Public Health Emergency are expiring. Billing teams must return to pre-PHE pharmacy billing requirements and procedures.

Action Required

Action needed
Immediately: Billing team must revert to pre-PHE pharmacy billing procedures for Medicaid patients. Review and update billing software settings to remove temporary COVID-19 accommodations. Verify current prior authorization requirements and documentation standards for pharmacy claims are restored to normal protocols.

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