MedicaidPrior AuthHigh impact
CSOCI Newsletter Vol. 02, No. 06
New Jersey Medicaid·NJ · Psychiatry·Prior Authorization
Effective date
Apr 1, 2002
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid/NJ FamilyCare requires prior authorization numbers from ValueOptions for all behavioral health services provided to children enrolled in Care Management Organizations (CMOs). Claims without proper PA numbers will be rejected with error codes 423 or 774.
Action Required
Immediately: Billing team must enter ValueOptions-issued PA numbers in block 23 of HCFA 1500 forms for all behavioral health services to children enrolled in CMOs. Use specific HCPCS codes (not bundled CSC02/CSC05 codes) when submitting claims. Contact ValueOptions at 1-877-652-7624 for PA number questions. Claims without PA numbers will be denied.