All PlansPrior AuthMedium impact
CBHS/PFC/CSOCI Newsletter Vol. 03, No. 06
New Jersey Medicaid·NJ · Psychiatry·Prior Authorization
We identified it
Jun 20, 2026
Summary
New prior authorization requirements have been established for mental health rehabilitation services provided in out-of-home residential settings. This policy specifically affects behavioral health and psychiatric care billing for residential treatment facilities.
Action Required
Immediately: Billing team must implement prior authorization requirements for all mental health rehabilitation services in residential settings. Contact the payer to obtain authorization before admitting patients to residential mental health facilities. Update billing workflows to verify authorization status before submitting claims. Claims without proper prior authorization will be denied.