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MedicaidReimbursementMedium impact

Newsletter Vol. 12, No. 84

New Jersey Medicaid·NJ·Provider Notice
Effective date
Sep 9, 2002
We identified it
Jun 20, 2026
Days to comply

Summary

New Jersey Medicaid and NJ FamilyCare increased reimbursement rates for selected clinic services including office visits, consultations, and preventive care codes. The new maximum fee allowances vary by provider type (specialist vs non-specialist) and modifier used.

Action Required

Action needed
Immediately: Billing team must update fee schedules in billing system with the new maximum allowable amounts for New Jersey Medicaid/NJ FamilyCare claims with service dates September 9, 2002 and after. Update rates for both specialist and non-specialist providers and ensure proper modifier usage (AV, WM, YD, YY, ZZ, ZI) as specified in the fee schedule.

Affected Billing Codes

90862
99201
99202
99203
99204
99205
99212
99213
99214
99215
99242
99243
99244
99245
99272
99273
99274
99275
99354
99355
99381
99382
99383
99384
99385
99386
99387
99391
99392
99393
99394
99395
99396
99397