MedicaidAdministrativeHigh impact
Newsletter Vol. 18, No. 06
New Jersey Medicaid·NJ·Provider Notice
Effective date
May 23, 2008
We identified it
Jun 20, 2026
Summary
Effective May 23, 2008, all non-pharmacy claims submitted electronically to New Jersey Medicaid (NJFC) must identify billing and pay-to providers using their National Provider Identifier (NPI) in the 837I, 837P, and 837D claim transactions. The previous contingency plan allowing provider ID numbers has expired, and claims submitted without valid NPIs will be rejected for payment unless the provider qualifies as an 'atypical provider' exempt from NPI requirements.
Action Required
By May 23, 2008: Billing team must ensure all electronic claims to New Jersey Medicaid include valid 10-digit NPIs for billing providers and pay-to providers in the correct 837 claim format fields (NM108=XX, NM109=NPI). Confirm NPI registration with Unisys Provider Enrollment (609-588-6074 or PO Box 4804, Trenton, NJ 08650-4804). Update billing software and third-party vendors/billing services to populate NPI fields and provider taxonomy codes (PRV segments) at both document and service-line levels for attending physicians, operating physicians, other providers, and rendering providers. Validate that postal codes are included for all provider segments. Atypical providers (precluded from NPI assignment) may continue using NJFC/Medicaid provider numbers. Consequence: Claims submitted without valid NPIs or with incorrect NPI information will be rejected and denied for payment.