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Newsletter Vol. 28, No.01

New Jersey Medicaid·NJ · Psychiatry, Family Medicine, Internal Medicine +1 more·Provider Notice
Effective date
Feb 1, 2018
We identified it
Jun 20, 2026
Days to comply

Summary

NJ FamilyCare now requires providers to bill only full units of service for time-based codes with no rounding up allowed. Face-to-face time must meet exact code requirements, and non-face-to-face time is not separately reimbursable.

Action Required

Action needed
Immediately: Billing team must update all time-based billing to require full units only - no rounding up permitted. Train providers that only face-to-face time counts toward billing requirements. Update billing system edits to prevent submission of partial units for psychotherapy codes 90832-90838. For home care services, bill one unit for 1-29 minutes, second unit for 30-44 minutes, etc. Document exact face-to-face times in patient records to support billing.

Affected Billing Codes

90791
90792
90832
90833
90834
90836
90837
90838
90853