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MedicaidBilling CodesMedium impact

Newsletter Vol. 14, No. 45

New Jersey Medicaid·NJ · PM&R (Physical Medicine & Rehab), Neurology, Psychiatry·Provider Notice
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

A new HCPCS code S5109 has been introduced for billing In-Home Supported Day Program Services under the Traumatic Brain Injury (TBI) Waiver Program. This code enables billing for specialized day program services delivered in home settings for TBI patients.

Action Required

Action needed
Billing team must add new HCPCS code S5109 to billing system for In-Home Supported Day Program Services under TBI Waiver Program. Update encounter forms and fee schedules. Ensure staff are trained on proper use of this code for TBI waiver patients receiving home-based day program services.

Affected Billing Codes

S5109