MedicaidReimbursementMedium impact

Newsletter Vol. 5, No. 42

Q: Who is affected by this change?

This affects New Jersey Medicaid Orthopedics, PM&R (Physical Medicine & Rehab), Neurology providers in NJ on Medicaid plans.

New Jersey Medicaid·NJ · Orthopedics, PM&R (Physical Medicine & Rehab), Neurology·Provider Notice

Effective date

Not stated

We identified it

Jun 20, 2026

Days to comply

—

Summary

Medicaid has changed reimbursement rates for medical suppliers and durable medical equipment (DME) that are priced 'By Report', meaning items without predetermined fee schedules. This affects how much providers will be reimbursed for custom or specialized DME items.

Action Required

Action needed

Immediately: Review current DME claims priced 'By Report' to understand new reimbursement structure. Contact medical suppliers to verify updated pricing information and adjust billing expectations accordingly. Monitor claim payments for DME items to ensure proper reimbursement under new rates.

Related policy hubs

New Jersey Medicaid policies NJ policy changes Orthopedics PM&R (Physical Medicine & Rehab)Neurology