MedicaidBilling CodesHigh impact
PFC/CSOCI Newsletter Vol. 07, No. 02
New Jersey Medicaid·NJ · Psychiatry, Pediatrics·Coding
Effective date
Apr 1, 2007
We identified it
Jun 20, 2026
Summary
Effective April 1, 2007, New Jersey's Division of Child Behavioral Health Services is replacing existing IIC Biopsychosocial Assessment billing codes (H0036TJU1/H0036TJU2) with new codes (H0018TJU1/H0018TJU2) and changing the billing unit from 15-minute increments to hourly billing. Providers must implement a new assessment template, obtain signed consent forms, submit assessments via Autofax within 10 business days, and comply with expanded documentation and collateral contact requirements.
Action Required
By April 1, 2007: (1) Billing team must immediately update billing system to replace old codes H0036TJU1 and H0036TJU2 with new codes H0018TJU1 ($113.00/hour) and H0018TJU2 ($85.00/hour). (2) Change billing configuration from 15-minute unit increments to hourly units, with maximum 3 hours per date of service and maximum 2 assessments per beneficiary per year. (3) IIC certified providers must download and implement the new IIC Biopsychosocial Assessment template from http://www.state.nj.us/dcf/dcbhs and use it for all assessments submitted on or after April 1, 2007. (4) Providers must obtain signed consent forms from youth/parents/guardians at face-to-face meetings granting access to school, medical, juvenile justice, and treatment records, and submit copies to ValueOptions with each assessment. (5) All assessments must be typewritten, submitted via Autofax to ValueOptions (new requirement), and completed within 10 business days of referral. (6) Providers must document mandatory collateral contacts with school/educational staff, juvenile justice system staff (if applicable), all behavioral health/treatment providers from prior 12 months, and extended family. (7) Billing team must verify that all IIC providers have DCBHS certification with IMDS Needs Assessment reliability score of 0.7 or above before processing claims. (8) Update claim rejection rules: claims using old codes H0036TJU1/H0036TJU2 after April 1, 2007 will be denied; claims billed in 15-minute increments will be rejected; claims lacking signed consent forms, proper template completion, or submitted after 10 business days will be denied. Strongly encourage attendance at training sessions (February 22 and March 1, 2007) for up to 2 staff per agency. Contact ValueOptions (1-877-652-7624) for authorization questions or Unisys Provider Services (1-800-776-6334) for billing/CMS 1500 form questions.