MedicaidCoverageMedium impact
Newsletter Vol. 31, No.25
New Jersey Medicaid·NJ · Infectious Disease, Family Medicine, Internal Medicine·Pharmacy
Effective date
Dec 1, 2021
We identified it
Jun 20, 2026
Summary
New Jersey's AIDS Drug Distribution Program (ADDP) will now cover administration of Cabenuva® long-acting HIV injections starting December 1, 2021. Providers should bill CPT 96372 for injection administration with reimbursement rates of $7.44 (specialist) or $6.32 (non-specialist).
Action Required
By December 1, 2021: Billing team must update system to bill CPT code 96372 for Cabenuva® injection administration for ADDP patients. Use 1500 claim form or 837P transaction for professional/clinic claims, or UB-04/837I for outpatient claims. Set reimbursement rates at $7.44 for specialists or $6.32 for non-specialists.