MedicaidBilling CodesMedium impact
Newsletter Vol. 5, No. 23
New Jersey Medicaid·NJ · Optometry·Coding
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid has activated additional E&M codes and HCPCS procedure codes specifically for optometrists, effective immediately and retroactive to January 1st. Optometrists can now use these codes for billing and may submit claim adjustments for services already provided since January 1st using different codes.
Action Required
Immediately: Billing team must update system to allow optometrists to bill the newly activated E&M and HCPCS codes listed in the policy attachment. For services provided since January 1st that were billed with other codes, submit claim adjustment requests using Form FD with 'Claim Correction' indicated and attach revised claim forms with applicable HCPCS codes. Resubmit previously denied claims with error code for procedure/provider specialty restrictions.