MedicaidPrior AuthMedium impact
Newsletter Vol. 19, No. 09
New Jersey Medicaid·NJ·Provider Notice
Effective date
Apr 1, 2009
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid will deny MAV transportation claims for skilled nursing facility beneficiaries if the system cannot find a corresponding paid skilled nursing facility claim and no prior authorization was obtained. Claims will be held for up to 90 days to verify SNF residency before denial.
Action Required
By April 1, 2009: Transportation providers must ensure prior authorization is obtained for all MAV transportation when skilled nursing facility is not the origin or destination. Billing team must verify SNF residency status before submitting claims to avoid Error Code 1601 denials. Allow up to 90 days for claim processing when SNF claims verification is pending.