MedicaidBilling CodesMedium impact
Newsletter Vol. 20, No. 01
New Jersey Medicaid·NJ · Dentistry·Provider Notice
Effective date
Jan 1, 2010
We identified it
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.
Action Required
Immediately: Billing team must update system to require prior authorization for codes D0417, D2740, D5991, D5710, D5711, D5720, and D5721. Configure D4341 and D4342 to allow once per year without prior auth for up to 4 quadrants. Update D1110 frequency to twice per rolling calendar year. Stop billing D8660 for clients over age 18. Verify NJ Medicaid eligibility at each appointment using REVS or eMEVS systems.