MedicaidPrior AuthHigh impact
Newsletter Vol. 32, No.08
New Jersey Medicaid·NJ · Psychiatry·Prior Authorization
Effective date
Apr 1, 2022
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid is resuming prior authorization requirements for mental health partial care services effective April 1, 2022. All prior auth requests must now include a completed Individual Recovery Plan (IRP) with required signatures from licensed clinician, member, and Medical Director.
Action Required
Effective April 1, 2022: Mental health partial care providers must submit prior authorization requests to local Medical Assistance Customer Center (MACC) using FD-07 form for new admissions (limited to 6 weeks). After comprehensive assessment, submit new prior auth with signed IRP for 90-day authorization periods. Ensure IRPs include all required signatures (clinician, member, Medical Director) and are not signed more than 7 days before start date. Missing signatures or improper documentation will result in prior authorization denials.