MedicaidAdministrativeHigh impact
Newsletter Vol. 19, No. 10
New Jersey Medicaid·NJ · Pharmacy·Provider Notice
Effective date
Apr 1, 2009
We identified it
Jun 20, 2026
Summary
Effective immediately, providers must leave the Group ID Field (NCPDP Field 301-C1) blank on all secondary claims for patient co-payment amounts when coordinating benefits with the State. Claims with a Group ID value in this field will be denied with Error Code 197 and NCPDP Error Code '06'. This correction addresses misdirection of Medicare Part D payments resulting from improper Group ID reporting.
Action Required
Immediately: Billing team must update all secondary claim submission processes to ensure the Group ID Field (NCPDP Field 301-C1) is left blank for all patient co-payment claims submitted to BIN 610515 with PCNs SUPPNJ, PAAD, or ADDP. Configure billing software to enforce this requirement and prevent Group ID values from populating this field on these specific claim types. Verify with all staff who submit secondary claims that this change has been implemented. Failure to comply will result in claim denials with Error Code 197 and misdirection of Medicare Part D payments to beneficiaries instead of the practice.