MedicaidAdministrativeMedium impact
Newsletter Vol. 21, No.24
New Jersey Medicaid·NJ · Pediatrics, Family Medicine·Provider Notice
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid requires reporting of 'Patient Responsibility Amount' on EPSDT claim forms and provides clarification on Medicaid/NJ FamilyCare cost sharing responsibilities when claims are eligible for Medicare or other insurance payments.
Action Required
Immediately: Billing team must update EPSDT claim forms to include Patient Responsibility Amount field. Review cost sharing procedures for dual-eligible patients with Medicare or other insurance coverage. Update billing workflows to ensure proper coordination of benefits for NJ FamilyCare claims.