Back to dashboard
MedicaidAdministrativeHigh impact

Medicaid Alert - MA2016-04

New Jersey Medicaid·NJ · Psychiatry·Provider Notice
Effective date
Feb 1, 2017
We identified it
Jun 20, 2026
Days to comply

Summary

New Jersey Medicaid has established strict rules for reporting dates of service on behavioral health claims effective February 1, 2017. Most behavioral health services must be billed with single dates only - span date reporting is prohibited for therapy, assessments, and most services, requiring separate claims for each date when services span multiple days.

Action Required

Action needed
By February 1, 2017: Billing team must update system to prevent span date reporting for most behavioral health services. Configure billing software to require separate claims for each date of service when behavioral health services are provided over multiple days. Only allow span dates for specific residential services (H0019 codes) and PACT services (H0040). Train staff that individual therapy, assessments, and group therapy must be billed as single dates only. Claims with improper span dates will be rejected.

Affected Billing Codes

90791
90792
90832
90833
90834
90836
90847
90853
90887
H0040
H0035
T1017
H0019
H0036
H0039
H2015
H2000
H0003
H0015
H2036
H0010
H0018
H0020
H0033