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New Jersey MedicaidMedicaid · Billing Codes · Coding · NJ · DentistryHigh impact

Newsletter Vol. 13, No. 44

Act
by Jun 1, 2003
Effective date
Jun 1, 2003
Identified
Jun 20, 2026

Summary

New Jersey Medicaid/NJ FamilyCare is implementing enhanced CDT procedure codes for comprehensive orthodontic treatment billing effective June 1, 2003. Providers must use code D8080 for appliance placement, D8080-22 for months 1-24 of treatment ($80/month), and D8080-52 for months 25-35 of treatment ($14/month). This replaces previous billing procedures and establishes specific reimbursement amounts and billing timelines.

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What to do

by Jun 1, 2003 · 7 steps
01Dental providers billing NJ Medicaid/NJ FamilyCare must update billing systems to use new enhanced CDT codes for comprehensive orthodontic treatment.
02Use D8080 ($493.00) for initial placement of comprehensive orthodontic appliance.
03Use D8080-22 ($80.00/month) for months 1-24 of treatment, starting billing on the day appliance insertion is completed.
04Use D8080-52 ($14.00/month) for months 25-35 of treatment with billing not to exceed 35 months total.
05Update internal fee schedules, billing software, and provider documentation.
06Billing team must ensure monthly billing cycles align with treatment timeline requirements.
07Claims submitted with dates of service on or after June 1, 2003 using old coding will be denied or require adjustment.

Codes mentioned

D8080

Original notice

Newsletter Vol. 13, No. 44
njmmis.com · Always check the source before changing claims.
View original ↗

Related changes

See all New Jersey Medicaid changes →
Medicaid Alert - MA-2003-05HighEffective Jul 1, 2003 · Provider NoticeNewsletter Vol. 13, No. 01LowEffective Jan 1, 2003 · Provider NoticeNewsletter Vol. 13, No. 02MediumEffective Jan 1, 2003 · CodingNewsletter Vol. 13, No. 03MediumNo effective date · Provider NoticeBrowse every New Jersey Medicaid change in the policy list

Related policy hubs

New Jersey Medicaid policiesNJ policy changesDentistryCode D8080

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