MedicaidBilling CodesMedium impact
Newsletter Vol. 8, No. 67
New Jersey Medicaid·NJ · Psychiatry·Coding
Effective date
Nov 1, 1998
We identified it
Jun 20, 2026
Summary
New Jersey DMAHS is adding two HCPCS procedure codes (90805 and 90807) for individual psychotherapy services with medical evaluation and management, effective for claims with service dates on or after November 1, 1998. Mental Health Clinics and Federally Qualified Health Centers must update their procedure code files and billing systems with the specified maximum fee allowances ($13.00 for 90805 and $26.00 for 90807).
Action Required
By November 1, 1998 (or immediately if current date is after): Billing team must add HCPCS codes 90805 and 90807 to the procedure code file in the billing system. Set maximum fee allowances at $13.00 for code 90805 (individual psychotherapy, 20-30 minutes with medical evaluation and management) and $26.00 for code 90807 (individual psychotherapy, 45-50 minutes with medical evaluation and management). Update the Manual for Independent Clinic Services, Chapter 10:66 with the attachment supplement. Train billing staff to apply the correct codes based on session duration. Retain the newsletter numerically behind the BLUE TAB marked "5" in procedure manuals for reference. Verify that Mental Health Clinics and Federally Qualified Health Centers in your network have made these updates to avoid claim denials or delays.