MedicaidBilling CodesMedium impact
Newsletter Vol. 25, No.08
New Jersey Medicaid·NJ · Psychiatry·Provider Notice
Effective date
Aug 1, 2015
We identified it
Jun 20, 2026
Summary
Mental Health Independent Clinics in New Jersey can now bill separately for medication management services (evaluation and management) provided by physicians or APNs to Medicaid recipients in partial care programs. These services were previously bundled into the partial care rate but are now billable as distinct E/M services using codes 99201UC or 99211UC, provided third-party insurance is billed first per coordination of benefits rules.
Action Required
Immediately: Billing team at Mental Health Independent Clinics providing partial care services must update billing system to enable separate billing for medication management E/M services. (1) Add CPT codes 99201UC and 99211UC to billing software for partial care encounters involving physician or APN medication management and physical assessment. (2) Update encounter forms/EMR templates to prompt providers to document medication management services separately from partial care therapeutic time. (3) Implement coordination of benefits rules: bill commercial/third-party insurance BEFORE billing Medicaid for these E/M services. (4) Train billing staff that Medical Director duties (intake, treatment planning, re-certification) remain bundled in partial care rates and should NOT be billed separately. Failure to coordinate with third-party payers first may result in Medicaid claim denials.