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MedicaidReimbursementHigh impact

Newsletter Vol. 13, No. 06

New Jersey Medicaid·NJ · Family Medicine, OB-GYN, General Practice·Provider Notice
Effective date
Sep 16, 2002
We identified it
Jun 20, 2026
Days to comply

Summary

New Jersey Medicaid/NJ FamilyCare increases reimbursement rates for 31 selected HCPCS procedure codes effective September 16, 2002. Family Planning Clinic providers must update billing systems to reflect the new maximum fee allowances for evaluation/management visits, family planning procedures, and related services.

Action Required

Action needed
Immediately: Billing team must update all NJ Medicaid/NJ FamilyCare fee-for-service fee schedules in the billing system to reflect new maximum reimbursement rates for the 31 affected HCPCS codes listed in the policy. Update billing software with modifier WF rates and modifier 52 rates where applicable (e.g., 99203 WF $83.70, 99203 WF-52 $79.70). Verify that claims submitted for service dates on or after September 16, 2002 use the updated fee allowances. Communicate changes to all providers and front desk staff. Failure to update rates may result in underbilling and lost revenue for Family Planning services.

Affected Billing Codes

11976
57452
57454
57511
58300
58301
90782
99201
99202
99203
99204
99205
99211
99212
99213
99214
99215
99395
G0001
Y7633
Y7634