MedicaidAdministrativeHigh impact
Newsletter Vol. 21, No.31
New Jersey Medicaid·NJ·Provider Notice
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid/FamilyCare has updated billing procedures for secondary claims when they are not the primary payer. Providers must use specific value codes (A1, A2, A7, B1, B2, B7, C1, C2, C7, A3, B3, C3, D3) on UB-04 forms and list all prior payments in form locator 54.
Action Required
Immediately: Billing team must update UB-04 claim forms for NJ Medicaid/FamilyCare secondary claims to use specific value codes: A1/B1/C1 for deductibles, A2/B2/C2 for coinsurance, A7/B7/C7 for copays, A3/B3/C3 for exhausted benefits, and D3 for patient responsibility. Update billing software to require all prior payments in form locator 54. For Medicare replacement plans, use payer code '082'. Attach TPL bypass letters for primary insurance denials. Claims with incorrect coding may be denied or delayed.