MedicaidPrior AuthHigh impact
Newsletter Vol. 29, No.05
New Jersey Medicaid·NJ · Geriatrics, Pediatrics·Prior Authorization
Effective date
Mar 1, 2019
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid has transferred Medical Day Care (MDC) prior authorization responsibility from Division of Aging Services to Division of Medical Assistance and Health Services. All MDC prior authorization requests must now be mailed to Monmouth Medical Assistance Customer Center with specific documentation requirements and new service codes for pediatric patients.
Action Required
Immediately: Update billing workflows to mail all Medical Day Care prior authorization requests to Monmouth Medical Assistance Customer Center at 100 Daniels Way, Freehold, NJ 07728. Verify Medicaid eligibility before submitting PA requests. Use service code Z1863 for Technology Dependent children and Z1864 for Medically Complex children in billing system. Submit required FD-411 forms and MCO authorization documentation for gap requests. Contact 732-863-4400 for questions.