MedicaidBilling CodesHigh impact
Newsletter Vol. 19, No. 18
New Jersey Medicaid·NJ·Pharmacy
Effective date
Jun 8, 2009
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid/NJ FamilyCare changed payment procedures for physician-administered prescription drugs, requiring all claims to be priced using the State's Master Drug File instead of previous reimbursement methods. Claims must include specific NDC numbers, quantities, and unit of measure qualifiers in proper format.
Action Required
By June 8, 2009: Billing team must update all physician-administered drug claims to include proper NDC formatting in Field 24A with 'N4' qualifier, 11-digit NDC number, three spaces, two-position unit of measure qualifier (F2, GR, ML, or UN), and quantity. Use www.njmmis.com website to verify correct unit of measure for each NDC. For J3490, J3590, and J9999 codes, submit original hard-copy claims to Unisys. Claims without proper NDC formatting will be denied with specific error codes.