MedicaidBilling CodesMedium impact
Medicaid Alert MA-2022-03
New Jersey Medicaid·NJ · OB-GYN, Family Medicine, General Practice +1 more·Coding
Effective date
Jan 1, 2022
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid is replacing two sets of teen-directed family planning HCPCS codes with consolidated codes effective January 1, 2022 and January 1, 2023. Code 99201 FP22 is replaced by 99203 FP22 for initial/annual visits (effective 1/1/2022), and codes 99393 FP52, 99394 FP52, and 99395 FP52 are replaced by 99213 FP22 for follow-up visits (effective 1/1/2023). The new codes combine E/M evaluation and management services with teen-directed family planning requirements.
Action Required
By December 31, 2021: Billing team must update billing software to stop accepting code 99201 FP22 for claims with service dates on or after January 1, 2022, replacing it with 99203 FP22. By December 31, 2022: Update system to stop accepting codes 99393 FP52, 99394 FP52, and 99395 FP52 for service dates on or after January 1, 2023, replacing them with 99213 FP22. Update encounter forms and provider templates to reflect new codes and billing qualifiers: 99203 FP22 can only be billed once per 12 months per member under 21; 99213 FP22 can only be billed after the 30-day period following an initial visit. Ensure providers understand that both the E/M services and all teen-directed family planning visit requirements must be documented and provided to receive reimbursement. Communicate these changes to all providers and clinical staff performing teen family planning services. Failure to use correct codes by effective date will result in claim denials.