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Newsletter Vol. 20, No. 14

New Jersey Medicaid·NJ · Dentistry·Provider Notice
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

New Jersey Medicaid Fee-For-Service program has revised criteria for orthodontic treatment coverage. This affects billing and prior authorization requirements for orthodontic services under NJ Medicaid.

Action Required

Action needed
Immediately: Review the complete policy document at https://www.njmmis.com/documentDownload.aspx?document=20-14.pdf to understand new orthodontic treatment criteria. Billing team must update prior authorization processes for NJ Medicaid orthodontic cases and ensure documentation meets revised criteria before submitting claims.

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