All PlansPrior AuthMedium impact
Newsletter Vol. 12, No. 11
New Jersey Medicaid·NJ · Psychiatry, Family Medicine, Internal Medicine·Prior Authorization
We identified it
Jun 20, 2026
Summary
New prior authorization requirements have been implemented for Partial Hospitalization Services. Healthcare providers must now obtain prior authorization before providing these intensive outpatient mental health services to ensure coverage and prevent claim denials.
Action Required
Immediately: Billing team and providers must begin obtaining prior authorization for all Partial Hospitalization Services before rendering care. Update billing system to flag these services for prior auth requirements. Contact utilization management department to establish workflow for authorization requests. Claims submitted without prior authorization will be denied.