MedicaidCoverageMedium impact
Newsletter Vol. 32, No.02
New Jersey Medicaid·NJ · Dentistry, Pediatrics·Provider Notice
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid has updated the criteria for orthodontic services and Health and Learning Disorders (HLD) coverage. This policy change affects billing and coverage requirements for orthodontic treatments and related services in New Jersey.
Action Required
Immediately: Review the full policy document at https://www.njmmis.com/documentDownload.aspx?document=32-02.pdf to understand updated orthodontic coverage criteria and HLD requirements. Billing team must update prior authorization processes and coverage verification procedures for orthodontic services. Update patient eligibility verification workflows to reflect new criteria.