MedicaidCoverageMedium impact
Newsletter Vol. 19, No. 54
New Jersey Medicaid·NJ · Dentistry, Oral & Maxillofacial Surgery·Eligibility
We identified it
Jun 20, 2026
Summary
NJ Medicaid/NJ FamilyCare will now reimburse outpatient hospital settings for dental services provided to fee-for-service clients with developmental disabilities and traumatic brain injuries. This expands coverage for specialized dental care in hospital outpatient departments for qualifying patients.
Action Required
Billing team should review the full policy document at https://www.njmmis.com/documentDownload.aspx?document=19-54.pdf to identify specific billing codes, documentation requirements, and eligibility criteria for outpatient hospital dental services. Update billing procedures for NJ Medicaid patients with developmental disabilities or traumatic brain injuries receiving dental care in hospital outpatient settings.