MedicaidReimbursementHigh impact
Newsletter Vol. 19, No. 43
New Jersey Medicaid·NJ·Eligibility
Effective date
Aug 3, 2009
We identified it
Jun 20, 2026
Summary
New Jersey is implementing a new Medicaid fee-for-service reimbursement methodology for hospital inpatient services, moving from hospital-specific DRG rates based on 1988 costs to a statewide base rate system with updated DRG weights. Physicians must now bill separately for inpatient services under their own Medicaid provider numbers instead of being included in hospital payments.
Action Required
By August 3, 2009: New Jersey hospitals must implement new DRG reimbursement system using statewide base rates instead of hospital-specific rates. Physicians providing inpatient services must enroll as Medicaid providers if not already enrolled and bill separately using CMS-1500 forms under their own provider numbers. Update billing systems to accommodate new DRG Version 24 grouper and separate physician billing requirements.