All PlansReimbursementMedium impact

Newsletter Vol. 9, No. 75

Q: Who is affected by this change?

This affects New Jersey Medicaid Family Medicine, Internal Medicine, General Practice providers in NJ on All Plans plans.

New Jersey Medicaid·NJ · Family Medicine, Internal Medicine, General Practice·Coding

Effective date

Not stated

We identified it

Jun 20, 2026

Days to comply

—

Summary

Maximum fee allowances for specified laboratory services using 1999 HCPCS codes have been reduced. This will result in lower reimbursement rates for affected lab procedures, impacting revenue for practices that perform these services.

Action Required

Action needed

Immediately: Review the full policy document at https://www.njmmis.com/documentDownload.aspx?document=9-75.pdf to identify specific laboratory codes affected. Billing team must update fee schedules and adjust revenue projections for impacted lab services. Notify providers of reduced reimbursement rates for planning purposes.

Related policy hubs

New Jersey Medicaid policies NJ policy changes Family Medicine Internal Medicine General Practice