MedicaidReimbursementMedium impact
Newsletter Vol. 9, No. 16
New Jersey Medicaid·NJ · OB-GYN, Family Medicine, General Practice·Provider Notice
Effective date
Jan 1, 1998
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid increased reimbursement rates for intrauterine device (IUD) insertion and removal procedures effective January 1, 1998, due to rising device costs. Billing teams must use specific HCPCS codes (W0001, W0002, W0004, W0008, E58301) with appropriate modifiers and complete Item 24H on HCFA 1500 claims to identify family planning services. Previously paid claims at old rates may be adjusted using the FD-999 form.
Action Required
Immediate: Update billing system to use the new HCPCS codes and fee schedules for IUD insertions and removals. Billing team must ensure Item 24H on HCFA 1500 claims is populated with '2' for standard family planning services or '3' for beneficiaries under 21 years of age (EPSDT). For insertions/removals by physicians, use base codes (W0001, W0002, W0004, W0008); for certified nurse-midwives, append modifier WM to base code and WF to follow-up modifier. Update claim submission workflows to reflect new maximum fee allowances by provider type. Submit FD-999 Claims Adjustment Forms for any services billed on or after January 1, 1998 that were previously paid at lower rates. Contact Office of Health Services Administration at (609) 588-2721 with questions.