MedicaidBilling CodesMedium impact
Newsletter Vol. 12, No. 52
New Jersey Medicaid·NJ · Psychiatry, Pain Management·Provider Notice
Effective date
Jun 1, 2002
We identified it
Jun 20, 2026
Summary
New Jersey Department of Human Services will continue reimbursing drug and alcohol clinics for methadone maintenance services provided to NJ FamilyCare (NJFC) beneficiaries eligible through WorkFirst NJ/General Assistance (WFNJ/GA) using HCPCS code Z2006 at a maximum allowance of $2.50. This reimbursement will continue until the Substance Abuse Initiative (SAI) program becomes available to provide these services. Eligible beneficiaries are identified by specific county codes ('01'-'21'), ID number positions ('70'), and plan designation 'G' on their Medicaid card.
Action Required
Immediately: Billing team must ensure claims for methadone maintenance services to WFNJ/GA beneficiaries are billed using HCPCS code Z2006 with maximum fee allowance of $2.50. Verify beneficiary eligibility by confirming: (1) county codes '01' through '21' in first two positions of Recipient ID number, (2) value '70' in 3rd and 4th positions of ID number, and (3) plan designation 'G' on Medicaid card. Confirm provider type is either drug/alcohol independent clinic (type 920) or Federally Qualified Health Center (type 950) and place of service is a clinic. Update billing software validation rules to enforce these eligibility criteria. Monitor for notification from DMAHS regarding transition to Substance Abuse Initiative (SAI) program, at which time billing instructions will change. Retain this newsletter for reference.