MedicaidPrior AuthHigh impact
Newsletter Vol. 11, No. 63
New Jersey Medicaid·NJ · Psychiatry·Prior Authorization
Effective date
Jul 15, 2001
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid and NJ FamilyCare now require prior authorization for Partial Hospitalization services after the first 90 days of treatment. Hospital providers must use only Revenue Codes 912 (daytime) and 913 (evening) for billing these services.
Action Required
By July 15, 2001: Billing team must update system to require prior authorization for Partial Hospitalization services after 90 days of initial treatment. Use only Revenue Codes 912 (daytime) and 913 (evening) for PH services billing to NJ Medicaid and FamilyCare. Resubmit any outstanding claims from February 15-July 14, 2001 that were inappropriately billed under other revenue codes. Claims for PH services using codes other than 912 and 913 are subject to recoupment.