MedicaidReimbursementHigh impact
Senior Services News Vol. 9, No. 02
New Jersey Medicaid·NJ · Geriatrics·Provider Notice
Effective date
Jul 1, 2005
We identified it
Jun 20, 2026
Summary
Effective July 1, 2005, New Jersey Medicaid reduced bed hold reimbursement for nursing facilities from 90% to 50% of the facility's per diem rate, and limited these payments to the first 10 days of hospitalization only. After day 10, Medicaid reimbursement for nursing facility services is discontinued entirely.
Action Required
By June 30, 2005: Billing team must update all billing system rules and reimbursement tables to reflect the new 50% bed hold rate (reduced from 90%) for New Jersey Medicaid claims. Configure system to automatically discontinue billing after the 10th day of hospitalization and deny any claims submitted beyond day 10. Update nursing facility billing procedures and staff training to reflect the new limitation. Educate providers that Medicaid will no longer reimburse for bed holds after day 10, regardless of prior practice. Failure to implement these changes will result in claim denials and revenue loss for bed hold periods beyond day 10.