MedicaidCoverageMedium impact
Newsletter Vol. 29, No.10
New Jersey Medicaid·NJ · Family Medicine, Internal Medicine, General Practice +2 more·Medical Policy
We identified it
Jun 20, 2026
Summary
New Jersey FamilyCare (Medicaid) provides coverage for SBIRT (Screening, Brief Intervention and Referral to Treatment) services for substance use disorders. Four billing codes are available with different reimbursement rates for specialists vs non-specialists/clinics, with services billable by physicians, PAs, APNs, clinical psychologists, and clinical social workers.
Action Required
Immediately: Billing team should verify ability to bill SBIRT codes 99408, 99409, G0396, and G0397 for NJ Medicaid patients. Update fee schedules with provided reimbursement rates (specialist vs non-specialist/clinic rates). Ensure provider credentials allow billing these services (physicians, PAs, APNs, clinical psychologists, clinical social workers only). Add SBIRT services to encounter forms for substance use screening and intervention.