MedicaidReimbursementMedium impact
Newsletter Vol. 12, No. 62
New Jersey Medicaid·NJ · Endocrinology, Pharmacy, General Practice +1 more·Provider Notice
Effective date
May 1, 2002
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid is establishing maximum fee allowances for three diabetic testing supply HCPCS codes (A4253, A4259, A4256) effective May 1, 2002. These fees align with Medicare rates and eliminate the need for 'by report' pricing attachments on medical supply claims. Suppliers must bill Medicare first for dual-eligible beneficiaries before submitting to Medicaid.
Action Required
By May 1, 2002: Billing team must update fee schedules in billing software to reflect the new maximum allowances for diabetic testing supplies: A4253 ($38.32 per 50 strips), A4259 ($12.19 per box lancets), and A4256 ($9.31 for calibrator solution/chips). Ensure claims for dual Medicare-Medicaid beneficiaries are billed to Medicare first before submitting as medical supply claims to New Jersey Medicaid. Remove 'by report' pricing for these codes and use the established maximums. Update billing staff training on the new workflow for dual-eligible beneficiaries.