MedicaidBilling CodesMedium impact
Newsletter Vol. 23, No.18
New Jersey Medicaid·NJ · Psychiatry·Coding
Effective date
Sep 1, 2013
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid clarified billing procedures for mental health and substance abuse services, specifying which CPT codes and modifiers each provider type can use. Independent mental health clinics can bill psychiatric diagnostic evaluations and psychotherapy codes with specific modifiers, while SAI and Non-SAI substance abuse providers have more limited code sets with different modifier requirements.
Action Required
Verify provider type classification in billing system and ensure correct modifier usage: Independent MH clinics must use modifiers SA, UC, UD, or 26 with psychiatric codes; SAI providers must use modifier HV; Non-SAI providers must use modifier HF. Update billing rules to prevent incorrect modifier/code combinations that will result in claim denials.