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Newsletter Vol. 32, No.13
Act
by Jul 1, 2022
Effective date
May 1, 2022
Identified
Jun 20, 2026
Summary
New Jersey Medicaid/NJ FamilyCare now allows Certified Midwives (CM) and Certified Professional Midwives (CPM) to enroll as providers, expanding beyond just CNMs. For fee-for-service claims starting July 1, 2022, midwives must add the 'SB' modifier to most professional services for reimbursement.
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What to do
by Jul 1, 2022 · 3 steps
01Billing team must update billing system to require 'SB' modifier for all midwife professional services in NJ Medicaid fee-for-service except CenteringPregnancy 99078 TH, family planning clinic services, laboratory services, vaccinations, and specified drug administration codes.
02Update encounter forms and billing software rules.
03Claims without proper SB modifier will not be reimbursed.
Codes mentioned
H1000H1001594005940959410594255942659430596105961259614595145962099202992039920499205992119921299213992149921599221992319923299238993419934236415517015170259020590255903059200593005941296127961609896098961989629940699407994739947454150541609265092651994609946199462994639938499385993869938799394993959939699397G9920G991951700564205650156605566065682056821570615710057150571605717057180574205742157452574545745557456574655751158100581101197611981119821198358300583019637296374963759637999078J1050J1726J1729J2788J2790J2791J2792J7294J7295J7296J7297J7298J7300J7301J7304J7307
Original notice
Newsletter Vol. 32, No.13
njmmis.com · Always check the source before changing claims.
Related changes
See all New Jersey Medicaid changes →Newsletter Vol. 35, No.08HighEffective Jul 1, 2025 · ReimbursementNewsletter Vol. 12, No. 85MediumEffective Sep 9, 2002 · Provider NoticeNewsletter Vol. 12, No. 82HighEffective Sep 9, 2002 · Provider NoticeMedicaid Alert MA2021-01HighEffective Apr 20, 2021 · CodingBrowse every New Jersey Medicaid change in the policy list
Related policy hubs
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