MedicaidReimbursementMedium impact
Newsletter Vol. 9, No. 13
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 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.
Action Required
Immediate action required for New Jersey Medicaid billing: (1) Billing 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); (2) Update billing software maximum fee allowances per fee schedule (W0001: $304.00, W0002: $137.00, W0004: $317.00, W0008: $150.00, 58301: $16.40); (3) Instruct certified nurse midwives and providers to ensure all IUD claims submitted on or after January 1, 1998 reflect correct coding; (4) Submit 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. Failure to complete Item 24H will result in claim denials or incorrect processing.