MedicaidCoverageHigh impact
Newsletter Vol. 23, No.21
New Jersey Medicaid·NJ · Psychiatry·Provider Notice
Effective date
Dec 1, 2013
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid now allows telepsychiatry services (psychiatric care via secure videoconference) to be billed as face-to-face mental health services when provided by psychiatrists or psychiatric advance practice nurses. Mental health clinics must bill under their own Medicaid provider number using existing outpatient codes (hospitals) or HCPCS codes with GT modifier (independent clinics), and must establish and obtain DMAHS approval for policies addressing 14 specific operational and technical requirements before providing services.
Action Required
IMMEDIATE ACTION REQUIRED: (1) Mental health clinic and hospital outpatient program leadership must contact their local Medical Assistance Customer Center (MACC) at (609) 631-4641 before offering any telepsychiatry services. (2) Develop and document comprehensive policies and procedures addressing all 14 requirements in this newsletter, including informed consent protocols, equipment specifications (minimum 384 kbps bandwidth, encryption, two-way audiovisual), secure transmission standards, client authentication, and documentation standards. (3) Submit policies to Division of Medical Assistance & Health Services (DMAHS) in consultation with Division of Mental Health and Addiction Services (DMHAS) or Children's System of Care (CSOC) for formal approval before implementation. (4) Billing team must: (a) configure billing software to bill telepsychiatry services under the clinic/hospital Medicaid provider number only (clinicians cannot bill directly); (b) for independent clinics, ensure use of appropriate HIPAA-compliant HCPCS codes with GT (via telemedicine) modifier; (c) for hospitals, use existing outpatient revenue codes; (d) update all service documentation to indicate telepsychiatry provision when applicable. (5) Clinical and administrative staff must establish affiliation agreements with off-site psychiatrists/APNs describing roles, responsibilities, and service coordination. (6) Ensure RN availability for physical evaluations if clinically required. (7) Confirm all providers are currently licensed in New Jersey. (8) Train front-desk and clinical staff on equipment operation, client authentication, and technical support protocols. Failure to obtain DMAHS approval before implementation may result in claim denials and compliance violations.