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MedicaidAdministrativeLow impact

Newsletter Vol. 11, No. 80

New Jersey Medicaid·NJ·Provider Notice
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

New Jersey Medicaid is implementing an override for Edit 893 (Third Party Liability) specifically for non-participating pharmacy providers. This change affects how TPL edits are processed for pharmacy claims when the provider is not contracted with Medicaid.

Action Required

Action needed
Immediately: Review pharmacy billing procedures to understand how Edit 893 TPL overrides will be processed. Billing team should monitor pharmacy claims for non-participating providers to ensure proper adjudication. Contact New Jersey Medicaid if questions arise about TPL processing for pharmacy claims.

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