MedicaidCoverageMedium impact
Newsletter Vol. 29, No.02
New Jersey Medicaid·NJ · Psychiatry, Family Medicine, Pediatrics·Medical Policy
Effective date
Jan 1, 2019
We identified it
Jun 20, 2026
Summary
New Jersey FamilyCare (Medicaid) now covers substance use disorder services for youth under 18 years of age, effective immediately. Previously, coverage was limited to beneficiaries 18 years and older.
Action Required
Immediately: Billing team must update system to allow billing of SUD services (codes 90791-90887, H0003-H2036) for NJ FamilyCare patients under 18 years old. Remove age restrictions in billing software. Update encounter forms to reflect new coverage. Prior authorization generally not required except for same-day conflicts identified during claims review.