MedicaidCoverageHigh impact
Newsletter Vol. 30, No.12
New Jersey Medicaid·NJ · Pediatrics, Family Medicine·Provider Notice
Effective date
Mar 23, 2020
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid (NJ FamilyCare) now covers pediatric and adolescent well visits via telehealth for members under 21 years old due to COVID-19 emergency. These visits must include developmental screenings, behavioral screenings, health risk assessments, and anticipatory guidance components.
Action Required
Immediately: Billing team must update systems to bill pediatric telehealth well visits using CPT codes 99381EP-99385EP or 99391EP-99395EP with Place of Service code '02' (telehealth). Providers must document in medical records that visit was completed via telehealth due to COVID-19 emergency and note any examination limitations. Schedule separate visits for missed components like vaccinations and physical exams.