MedicaidAdministrativeHigh impact
Newsletter Vol. 5, No. 39
New Jersey Medicaid·NJ·Provider Notice
Effective date
Jul 1, 1995
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid is transitioning from the current 1500 NJ claim form to the HCFA 1500 (12-90) form effective July 1, 1995. Providers must use the HCFA 1500 (12-90) form with red drop-out ink and bar coding for all claims submitted on or after October 1, 1995. Continuation/wraparound claims will no longer be accepted; each claim must be a separate document with summarized totals.
Action Required
By September 30, 1995: Billing team must deplete current 1500 NJ claim form stock. By October 1, 1995: Billing team must transition to HCFA 1500 (12-90) forms with red drop-out ink and bar coding for all New Jersey Medicaid claims. Update billing workflows to eliminate continuation claims—each claim must be a separate, summarized document with total charges. Obtain HCFA 1500 forms from current vendor network (no longer supplied by NJ Medicaid). Contact Unisys Provider Services at 1-800-776-6334 for field-by-field completion instructions. Failure to comply after October 1, 1995 will result in delayed claim processing or rejection.