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New Jersey MedicaidMedicaid · Billing Codes · Provider Notice · NJ · DentistryMedium impact

Newsletter Vol. 20, No. 01

Act
immediately
Effective date
Jan 1, 2010
Identified
Jun 20, 2026

Summary

New Jersey Medicaid has added new dental procedure codes, revised prior authorization requirements for periodontal services and denture rebasing, and updated frequency limits for prophylaxis and orthodontic assessments.

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What to do

immediately · 5 steps
01Billing team must update system to require prior authorization for codes D0417, D2740, D5991, D5710, D5711, D5720, and D5721.
02Configure D4341 and D4342 to allow once per year without prior auth for up to 4 quadrants.
03Update D1110 frequency to twice per rolling calendar year.
04Stop billing D8660 for clients over age 18.
05Verify NJ Medicaid eligibility at each appointment using REVS or eMEVS systems.

Codes mentioned

D0417D2740D3222D5991D4341D4342D1110D5710D5711D5720D5721D8660D9110D0150D0120D0145

Original notice

Newsletter Vol. 20, No. 01
njmmis.com · Always check the source before changing claims.
View original ↗

Related changes

See all New Jersey Medicaid changes →
Newsletter Vol. 13, No. 47HighEffective Jul 1, 2003 · CodingMedicaid Alert - MA-2003-05HighEffective Jul 1, 2003 · Provider NoticeNewsletter Vol. 14, No. 16HighEffective Apr 1, 2004 · Provider NoticeNewsletter Vol. 18, No. 08HighEffective Jan 1, 2007 · Provider NoticeBrowse every New Jersey Medicaid change in the policy list

Related policy hubs

New Jersey Medicaid policiesNJ policy changesDentistryCode D0417Code D2740Code D3222Code D5991Code D4341Code D4342Code D1110Code D5710Code D5711Code D5720Code D5721Code D8660Code D9110Code D0150Code D0120Code D0145

Summaries are AI-assisted. Always confirm against the original payer notice.

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