MedicaidReimbursementHigh impact
Newsletter Vol. 12, No. 05
New Jersey Medicaid·NJ · Geriatrics, Palliative Care·Reimbursement
Effective date
Jul 1, 2001
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid increased reimbursement rates for Personal Care Assistant (PCA) and Homemaker services effective July 1, 2001, across multiple waiver programs and fee-for-service plans. Billing teams must update rates in their systems and reprocess prior underpaid claims using the new maximum allowable amounts for 11 procedure codes.
Action Required
IMMEDIATE: Billing team must update all billing system fee schedules with the new maximum allowable rates for procedure codes Y7334, Z1200, Y7444, Z1820, Z1821, Z1600, Z1611, Z1605, Z1612, Z1824, and Z1825 (ranging from $5.88 to $15.50 per unit). For claims already submitted and paid before September 20, 2001, the system will automatically reprocess if usual and customary charges met or exceeded new rates. For claims where billed amounts are less than new rates, billing staff must manually submit MMIS Claim Adjustment Forms (FD-999) with explanation of why prior charges do not reflect usual and customary rates. Update billing software rules and fee tables before reprocessing any claims. Contact Donald Hartz at (609) 588-2621 for Medicaid/FamilyCare questions or DHSS Office of Waiver and Program Administration at (609) 584-4984 for homemaker services questions.