MedicaidAdministrativeMedium impact
Newsletter Vol. 22, No.12
New Jersey Medicaid·NJ · Geriatrics, PM&R (Physical Medicine & Rehab), Wound Care +1 more·Provider Notice
We identified it
Jun 20, 2026
Summary
The Medical Exception Process for Long Term Care services has been expanded, potentially allowing for additional coverage scenarios or streamlined approval processes for services that previously required more extensive review.
Action Required
Billing team should download and review the full policy document at https://www.njmmis.com/documentDownload.aspx?document=22-12.pdf to understand specific changes to the Medical Exception Process. Update workflows for long-term care billing to incorporate any new exception criteria or documentation requirements.