MedicaidPrior AuthMedium impact

CBHS/PFC/CSOCI Newsletter Vol. 03, No. 01

Q: Who is affected by this change?

This affects New Jersey Medicaid Psychiatry, Family Medicine, Internal Medicine, Pediatrics providers in NJ on Medicaid plans.

New Jersey Medicaid·NJ · Psychiatry, Family Medicine, Internal Medicine +1 more·Prior Authorization

Effective date

Not stated

We identified it

Jun 20, 2026

Days to comply

—

Summary

CBHS/PFC/CSOCI has updated authorization procedures for mental and behavioral health services when beneficiaries are receiving Care Management Organization (CMO) services. This change affects how prior authorization requests must be submitted for mental health treatment in coordinated care situations.

Action Required

Action needed

Immediately: Billing and authorization staff must review the updated CBHS/PFC/CSOCI authorization procedures for mental/behavioral health services involving CMO beneficiaries. Update prior authorization workflows to comply with new CMO coordination requirements. Download the full policy document from njmmis.com to understand specific procedural changes.

Related policy hubs

New Jersey Medicaid policies NJ policy changes Psychiatry Family Medicine Internal Medicine Pediatrics