MedicaidBilling CodesMedium impact
Newsletter Vol. 13, No. 55
New Jersey Medicaid·NJ·Provider Notice
Effective date
Jan 1, 2003
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid and NJ FamilyCare updated the list of approved practitioner-administered drugs with three effective dates: (1) One new HCPCS code (Q4053 for Neulasta) added effective July 1, 2003; (2) Reimbursement rates changed for 11 existing drug codes effective January 1, 2003; (3) One code (C9119) deleted effective August 1, 2003 with replacement code Q4053. Billing teams must update fee schedules and code submissions accordingly.
Action Required
By August 1, 2003: Billing team must (1) immediately update fee schedules in billing system for the 11 drug codes with changed reimbursement rates (J0150, J0300, J0640, J0706, J1626, J1650, J1835, J2000, J2820, J9150, S0023) to reflect new maximum fee allowances; (2) add Q4053 (Neulasta per 1 mg, $491.67 max fee) to system effective July 1, 2003; (3) delete code C9119 and replace with Q4053 effective August 1, 2003; (4) instruct providers to enter the lower of average wholesale price (AWP) or acquisition cost in block 24F on CMS 1500 claim forms. Update billing software and provider documentation. Failure to implement these changes will result in claim denials and payment delays for practitioner-administered drugs.