MedicaidAdministrativeMedium impact
Newsletter Vol. 15, No. 10
New Jersey Medicaid·NJ · Palliative Care·Provider Notice
Effective date
Aug 1, 2005
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid has implemented automatic PR-1 deduction processing for nursing facility and hospice claims through their MMIS system. Hospice providers must now ensure claims don't span calendar months and will see new error codes during processing.
Action Required
Immediately: Hospice billing teams in New Jersey must ensure all claims have matching month/year for 'service from' and 'service thru' dates - claims spanning calendar months will be denied with Error Code 0113. Update billing system edits to prevent month-spanning claims. Monitor for new informational error codes 0521, 0531, 1611, 0915, and 1612 during claim processing.