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MedicaidAdministrativeMedium impact

Newsletter Vol. 19, No. 35

New Jersey Medicaid·NJ·Provider Notice
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

New Jersey Medicaid requires pharmacies to properly report other insurance payments and patient paid amounts on pharmacy claims. New error codes 2096 and 2110 will deny claims missing required payment information when other insurance or Medicare Part D is involved.

Action Required

Action needed
Pharmacy billing teams must ensure all pharmacy claims with other insurance or Medicare Part D coverage include properly completed Patient Paid Amount field (433-DX) and Other Payer Amount field (431-DV). Claims missing this information will be denied with error codes 2096 or 2110. Update billing system validation rules to prevent submission of incomplete claims.