All PlansPrior AuthMedium impact
Newsletter Vol. 19, No. 57
New Jersey Medicaid·NJ · Dentistry, Oral & Maxillofacial Surgery·Prior Authorization
We identified it
Jun 20, 2026
Summary
New prior authorization requirements have been established for dental encounter visits associated with dental services. This policy specifically affects medical practices that provide dental-related services and requires prior authorization approval before rendering certain dental services.
Action Required
Immediately: Billing team must review all dental encounter visit procedures to identify which services require prior authorization. Update billing workflows to obtain prior authorization before scheduling or providing dental services. Train front desk staff to verify prior authorization requirements for all dental-related appointments. Claims for services requiring prior authorization will be denied if authorization is not obtained.