All PlansReimbursementMedium impact
Newsletter Vol. 7, No. 53
New Jersey Medicaid·NJ·Provider Notice
We identified it
Jun 20, 2026
Summary
New criteria have been established for approval of hospital offsite locations to receive hospital-based reimbursement rates. This policy defines requirements that offsite facilities must meet to qualify for higher hospital reimbursement versus lower outpatient facility rates.
Action Required
Billing team should review the complete policy document at https://www.njmmis.com/documentDownload.aspx?document=7-53.pdf to understand specific approval criteria for hospital offsite locations. Verify current facility designations and reimbursement rates. Contact hospital partners to confirm their offsite locations meet the new criteria to ensure proper reimbursement levels.