MedicaidPrior AuthMedium impact
Medicaid Alert - MA-2002-03
New Jersey Medicaid·NJ · Psychiatry, Pediatrics·Prior Authorization
Effective date
Mar 1, 2002
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid revised prior authorization forms FD-07 and FD-07A to include Children's System of Care Initiative (CSOCI) mental health services (residential services, behavioral assistance, crisis management, intensive in-home, and care management organization services). Providers must use the revised 09/01 versions of these forms for CSOCI service requests, though implementation is phased and varies by service area. Currently, all CSOCI services are authorized by the child's Care Management Organization (CMO), not through standard prior authorization procedures.
Action Required
Immediately: Mental health providers in New Jersey rendering services to children must obtain and begin using revised FD-07 (rev. 09/01) and FD-07A (rev. 09/01) forms for all prior authorization requests. Billing team should: (1) Order revised forms from Unisys (P.O. Box 4804, Trenton, NJ 08650-4804, www.njmmis.com, or 1-800-776-6334); (2) Update internal documentation to clarify that CSOCI services are currently authorized by the CMO, not through standard FD-07/FD-07A submission to Unisys; (3) Do NOT attempt to enroll as a separate 'CSOCI Provider'—existing Medicaid/NJ FamilyCare enrollment is sufficient; (4) When a CMO contacts provider to deliver CSOCI services, confirm whether to bill Unisys (for Medicaid-reimbursable services like individual psychotherapy) or bill the CMO directly (for non-Medicaid services like yoga instruction); (5) Monitor for future DMAHS newsletters indicating when CSOCI services are implemented in your service area before submitting authorization requests; (6) Ensure all services provided to CMO-enrolled children are included in the child's Individual Service Plan and CMO-approved. Do not contact Unisys or DMAHS about new CSOCI services until implementation confirmation is received for your area. Questions: Contact Office of Utilization Management, Mental Health Services Unit at (609) 588-2726 for prior auth procedures or Unisys Provider Services at 1-800-776-6334 for billing procedures.