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New Jersey MedicaidMedicaid · Reimbursement · Provider Notice · NJ · OB-GYN, Family Medicine, General PracticeMedium impact

Newsletter Vol. 9, No. 13

Effective date
Jan 1, 1998
Identified
Jun 20, 2026

Summary

New Jersey Medicaid is updating reimbursement rates for intrauterine device (IUD) insertion and removal services provided by certified nurse midwives, effective January 1, 1998. Providers must now complete Item 24H on HCFA 1500 claims with family planning service indicators (code 2 or 3 for EPSDT) to identify claims properly. Maximum fee allowances have been updated for all IUD-related codes.

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What to do

Action · 5 steps
01Immediate action required for New Jersey Medicaid billing.
02Billing team must update claim submission procedures to require completion of Item 24H (family planning indicator field) on all HCFA 1500 forms for IUD insertion/removal services—enter '2' for general family planning or '3' if beneficiary is under 21 (EPSDT).
03Update billing software maximum fee allowances per fee schedule (W0001: $304.00, W0002: $137.00, W0004: $317.00, W0008: $150.00, 58301: $16.40).
04Instruct certified nurse midwives and providers to ensure all IUD claims submitted on or after January 1, 1998 reflect correct coding.
05Submit FD-999 Claims Adjustment Forms for any previously paid claims at old rates for dates of service on/after January 1, 1998 to request additional reimbursement.
If missed: Failure to complete Item 24H will result in claim denials or incorrect processing.

Codes mentioned

W0001W0002W0004W000858301

Original notice

Newsletter Vol. 9, No. 13
njmmis.com · Always check the source before changing claims.
View original ↗

Related changes

See all New Jersey Medicaid changes →
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Related policy hubs

New Jersey Medicaid policiesNJ policy changesOB-GYNFamily MedicineGeneral PracticeCode W0001Code W0002Code W0004Code W0008Code 58301

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