MedicaidBilling CodesMedium impact
CSOCI Newsletter Vol. 02, No. 04
New Jersey Medicaid·NJ · Psychiatry, Pediatrics·Provider Notice
Effective date
May 1, 2002
We identified it
Jun 20, 2026
Summary
This New Jersey policy establishes reimbursement procedures for JCAHO-accredited residential treatment centers (RTCs) when residents are temporarily absent for hospital or therapeutic leave. Providers can bill for up to 14 continuous days of bed reservation per episode using specific HCPCS codes (Y9949, Y9950, Y9951, Y9952). Claims must use HCFA 1500 forms with proper coding, and billing dates cannot span multiple months or mix leave types on the same line.
Action Required
Immediately: Billing team must update claim submission procedures to use correct HCPCS codes (Y9949–Y9952) when billing for hospital leave or therapeutic leave at JCAHO-accredited RTCs. Verify contract status with Division of Youth and Family Services to select appropriate codes (contracted vs. non-contracted). Implement system rules to: (1) ensure dates on same billing line do not exceed one month, (2) prevent mixing hospital leave and therapeutic leave dates on same line, (3) separate regular service dates from leave dates on distinct lines. Train billers on full-day definition (midnight to midnight absence = billable leave day; any facility presence during calendar day = bill full-day mental health rehabilitation services instead). Contact Unisys Provider Services (1-800-776-6334) with billing procedure questions.