MedicaidReimbursementMedium impact
Newsletter Vol. 6, No. 04
New Jersey Medicaid·NJ·Provider Notice
Effective date
Feb 5, 1996
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid is reducing reimbursement rates for protein replacement supplements, specialized infant formulas, and food oils effective February 5, 1996. Payment will change from 150% of AWP to AWP minus volume discount plus dispensing fee, or usual and customary charge, whichever is lower.
Action Required
Before February 5, 1996: Pharmacy billing team must update reimbursement calculations in billing system for protein replacement supplements, specialized infant formulas, and food oils for New Jersey Medicaid claims. Change from 150% of AWP to AWP minus volume discount plus dispensing fee (or usual and customary charge if lower). Verify system calculates volume discounts per N.J.A.C. 10:51-1.6 and dispensing fees per N.J.A.C. 10:51-1.7.