MedicaidCoverageMedium impact
Newsletter Vol. 25, No.09
New Jersey Medicaid·NJ·Provider Notice
Effective date
Aug 1, 2015
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid reminds providers that children under 21 are entitled to all medically necessary services under EPSDT, regardless of state plan limitations. For services not in the state plan, contact the patient's health plan to coordinate coverage and delivery.
Action Required
Immediately: When treating Medicaid patients under 21, do not limit services based on state plan restrictions. If a medically necessary service is not covered under the standard state plan, contact the patient's health plan (number on member ID card) to coordinate coverage before providing services. Update staff training on EPSDT coverage rules.