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New Jersey MedicaidMedicaid · Billing Codes · Provider Notice · NJMedium impact

Newsletter Vol. 13, No. 55

Act
by Aug 1, 2003
Effective date
Jan 1, 2003
Identified
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.

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What to do

by Aug 1, 2003 · 2 steps
01Billing 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.
02Update billing software and provider documentation.
If missed: Failure to implement these changes will result in claim denials and payment delays for practitioner-administered drugs.

Codes mentioned

Q4053J0150J0300J0640J0706J1626J1650J1835J2000J2820J9150S0023C9119

Original notice

Newsletter Vol. 13, No. 55
njmmis.com · Always check the source before changing claims.
View original ↗

Related changes

See all New Jersey Medicaid changes →
Newsletter Vol. 12, No. 81MediumEffective Jan 1, 2002 · Provider NoticeNewsletter Vol. 14, No. 53HighEffective Jan 1, 2004 · Provider NoticeNewsletter Vol. 19, No. 18HighEffective Jun 8, 2009 · PharmacyNewsletter Vol. 13, No. 01LowEffective Jan 1, 2003 · Provider NoticeBrowse every New Jersey Medicaid change in the policy list

Related policy hubs

New Jersey Medicaid policiesNJ policy changesCode Q4053Code J0150Code J0300Code J0640Code J0706Code J1626Code J1650Code J1835Code J2000Code J2820Code J9150Code S0023Code C9119

Summaries are AI-assisted. Always confirm against the original payer notice.

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