MedicaidBilling CodesMedium impact
Newsletter Vol. 11, No. 57
New Jersey Medicaid·NJ · OB-GYN, Family Medicine, Internal Medicine +1 more·Provider Notice
Effective date
Jun 1, 2001
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid and NJ FamilyCare fee-for-service programs now reimburse for Lunelle Contraceptive Injection using HCPCS code W9353 (drug cost based on lower of AWP or acquisition cost, capped at $24.95) and CPT code 90782 (administration fee of $2.50). This is a correction to a previous newsletter establishing reimbursement pathways for this contraceptive injection effective June 1, 2001.
Action Required
By June 1, 2001: Billing team must implement reimbursement coding for Lunelle Contraceptive Injection. (1) Configure billing system to bill W9353 for drug cost—enter the lower of AWP or acquisition cost in BLOCK 24G on CMS-1500 claim forms (currently $24.95 maximum based on AWP). (2) Bill CPT 90782 for the injection administration at $2.50 flat fee. (3) Providers may also bill an appropriate E/M code (e.g., 99201-99215) for the office visit if applicable. (4) Train billing staff and providers on the two-code structure. (5) Update encounter forms and system templates to include both codes when Lunelle is administered to NJ Medicaid or NJ FamilyCare beneficiaries. Note: This policy only applies to fee-for-service programs; HMOs receive this for information only. Failure to use correct codes will delay or deny reimbursement.