MedicaidReimbursementLow impact
Newsletter Vol. 9, No. 09
New Jersey Medicaid·NJ·Pharmacy
Effective date
Dec 30, 1998
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid has suspended Federal Upper Limits (FUL) for several generic drugs including Amitriptyline, Triavil, Urecholine, Soma, and Serax. Reimbursement will now be based on AWP minus 10% plus dispensing fees, or the provider's usual and customary charge, whichever is lower.
Action Required
Pharmacy billing staff should update pricing for affected medications (Amitriptyline HCl, Triavil, Urecholine, Soma, Serax) to bill at AWP minus 10% plus dispensing fees for NJ Medicaid, PAAD, CFD, and General Assistance claims. Contact Chief of Pharmaceutical Services at (609) 588-2724 with questions.