MedicaidBilling CodesMedium impact
Newsletter Vol. 6, No. 25
New Jersey Medicaid·NJ · Psychiatry·Medical Policy
Effective date
Jun 15, 1996
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid introduces new HCPCS codes (W9853, W9854, W9857) for postpartum mental health disorder evaluation and treatment, with specific billing packages and fee allowances for psychiatrists and psychiatric nurse practitioners. These services require no prior authorization and are exempt from the $900 threshold.
Action Required
By June 15, 1996: Billing team must add new HCPCS codes W9853, W9854, and W9857 to billing system with respective fee allowances ($177/$143, $37/$29.90, $128/$103 based on provider type). Update system to restrict usage to qualified psychiatrists and psychiatric CNP/CNS only, not mental health clinic settings. Configure codes as exempt from prior authorization and $900 threshold. Train billing staff that W9853 is limited to one occurrence per pregnancy and appropriate alternative psychiatric codes must be used when multiple practitioners are involved.