MedicaidBilling CodesHigh impact
Newsletter Vol. 19, No. 06
New Jersey Medicaid·NJ · OB-GYN·Provider Notice
Effective date
Jul 11, 2008
We identified it
Jun 20, 2026
Summary
New Jersey FQHCs must use new encounter code T1015 with modifier HD for delivery and OB/GYN surgical claims to receive proper Medicaid fee-for-service reimbursement. FQHCs will now be reimbursed at the higher of their PPS rate or the Medicaid fee-for-service rate for these services.
Action Required
Immediately: FQHC billing teams must add procedure code T1015 with modifier HD to all delivery and OB/GYN surgical encounters for Medicaid fee-for-service beneficiaries with service dates on or after July 11, 2008. Update billing system to require this code in addition to each delivery and OB/GYN surgical encounter. Submit separate quarterly wraparound reports using Worksheets 2 Support Schedules C, D, E, and F for managed care deliveries and OB/GYN surgeries. Reference approved procedure codes list on njmmis.com website.