MedicaidReimbursementMedium impact
Medicaid Alert - MA-97-4
New Jersey Medicaid·NJ·Provider Notice
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid has updated reimbursement methodology for hospital services through Diagnosis Related Groups (DRG) assignment. This affects how hospital-based services are paid and may impact billing procedures for providers working with NJ Medicaid patients.
Action Required
Review the complete MA-97-4 policy document at njmmis.com to understand specific DRG assignment changes. Billing team should verify if practice has any hospital-based billing arrangements with NJ Medicaid and update reimbursement expectations accordingly. Coordinate with hospital billing departments if applicable.