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.
Get alerts when payers change rules like this one
We check New Jersey Medicaid and other payers every day and email you when a change matches your specialty and state.
Get New Jersey Medicaid alertsPolicy Monitoring is free. No card required.
What to do
Action · 5 steps
01Before 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.
02Change from 150% of AWP to AWP minus volume discount plus dispensing fee (or usual and customary charge if lower).
03Verify system calculates volume discounts per N.J.A.C.
0410:51-1.6 and dispensing fees per N.J.A.C.
0510:51-1.7.
Original notice
Newsletter Vol. 6, No. 04
njmmis.com · Always check the source before changing claims.