MedicaidBilling CodesHigh impact
Newsletter Vol. 29, No.11
New Jersey Medicaid·NJ · Psychiatry·Provider Notice
Effective date
Jul 1, 2019
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid now requires residential substance use disorder treatment facilities to offer Medication-Assisted Treatment (MAT) as a patient choice starting July 1, 2019. Providers offering MAT must bill rehabilitation codes (H0018 or H0019) with modifier HF plus an additional modifier (U1 for methadone, U2 for non-methadone) and apply corresponding per diem rate increases ($5.90/day for methadone, $17.54/day for non-methadone).
Action Required
By July 1, 2019: Billing team must update billing software to recognize and correctly process the following code and modifier combinations: H0019HF, H0019HFU1, H0019HFU2, H0018HF, H0018HFU1, and H0018HFU2. Ensure per diem rates are applied correctly (base rate plus $5.90/day for U1 methadone codes; base rate plus $17.54/day for U2 non-methadone codes). Configure system to prevent billing more than one code and modifier combination per day per resident. Update provider documentation and encounter forms to clarify MAT billing requirements. Providers must document the type of MAT provided (methadone vs. non-methadone) on daily billing records. Failure to apply correct modifiers and rates will result in claim denials or underpayment.