MedicaidAdministrativeMedium impact
Newsletter Vol. 13, No. 56
New Jersey Medicaid·NJ · Pathology·Coding
Effective date
Jul 1, 2003
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid/NJ FamilyCare now allows a billing laboratory within the same corporate structure as a servicing laboratory to bill directly for laboratory services provided by that servicing laboratory. Billing laboratories must report the servicing laboratory's Medicaid provider number on claim forms—either in Field 33 for all services from the servicing lab, or in Field 24K when claims include a mix of services.
Action Required
Immediately: Billing team must update claim submission procedures for New Jersey Medicaid/NJ FamilyCare laboratory services. (1) For claims where ALL laboratory services are provided by a servicing laboratory within the same corporate structure: enter the servicing laboratory's Medicaid provider number in Field 33 (PIN #) on CMS 1500 paper forms or Field Locator 33 in electronic claims. (2) For claims with MIXED services (some from servicing lab, some from other sources): enter the servicing laboratory's Medicaid provider number in Field 24K on CMS 1500 paper forms or Field Locator 24K in electronic claims. (3) Update billing software and submission templates to enforce correct provider number reporting based on service origin. Update staff training materials on this corporate entity billing policy. Failure to report correct provider numbers will result in claim denials or delayed reimbursement.