MedicaidDocumentationHigh impact
Newsletter Vol. 12, No. 101
New Jersey Medicaid·NJ · Pediatrics·Provider Notice
Effective date
Dec 1, 2002
We identified it
Jun 20, 2026
Summary
New Jersey requires EPSDT/PDN service providers to submit comprehensive clinical summaries to DMAHS every two months for all beneficiaries receiving these services. Initial summaries must be submitted by December 15, 2002, with specific documentation requirements including clinical status changes, procedures, hospitalizations, outcomes, provider contact information, and parental authorization for information disclosure.
Action Required
By December 15, 2002: Providers billing EPSDT/PDN services must submit initial comprehensive clinical summaries to DMAHS Office of Utilization Management. Billing/clinical staff must establish a bi-monthly submission process and ensure all clinical documentation includes: detailed written status updates with any clinical changes, specific procedures/interventions with frequency/dates/times, hospital discharge summaries if applicable, clinical outcomes at end of reporting period, all specialist names and phone numbers, and parent/legal guardian authorization for information disclosure. Subsequent summaries must be submitted every two months thereafter. Route all submissions to: New Jersey Department of Human Services, Division of Medical Assistance and Health Services, Office of Utilization Management, Mail Code 17, P.O. Box 712, Trenton, New Jersey 08625-0712. Failure to submit required documentation will result in denial of service reauthorization.