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New Jersey MedicaidMedicaid · Billing Codes · Coding · NJ · Orthopedics, Podiatry, Physical Therapy +2 moreHigh impact

Newsletter Vol. 5, No. 13

Act
immediately
Effective date
Not stated in the notice
Identified
Jun 20, 2026

Summary

New Jersey Medicaid has added HCPCS procedure codes and maximum fee allowances for prosthetic and orthotic services, effective immediately. Billing teams must update their fee schedules and coding references to include these new reimbursable services and their corresponding payment rates.

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What to do

immediately · 4 steps
01Billing team must obtain and review the complete attachment (Supplement to Subchapter Prosthetic and Orthotic Services Manual) to identify all new HCPCS codes and maximum fee allowances.
02Update billing software fee schedules and coding databases to reflect these new codes and reimbursement rates for all prosthetic and orthotic services submitted to New Jersey Medicaid.
03File this newsletter numerically behind the BLUE TAB MARKED HCPCS in the Prosthetic and Orthotic Services Manual for reference.
04Providers submitting prosthetic and orthotic claims must use only the updated codes and fee allowances; failure to do so may result in claim denials or incorrect reimbursement.

Codes mentioned

L3010L3020L3030L3070L3080L3090L5200L5210L5220

Original notice

Newsletter Vol. 5, No. 13
njmmis.com · Always check the source before changing claims.
View original ↗

Related changes

See all New Jersey Medicaid changes →
Newsletter Vol. 13, No. 25HighEffective Apr 15, 2003 · CodingNewsletter Vol. 26, No. 09HighEffective Aug 1, 2016 · CodingNewsletter Vol. 8, No. 40HighEffective Jan 1, 1998 · CodingNewsletter Vol. 8, No. 41HighEffective Jan 1, 1998 · CodingBrowse every New Jersey Medicaid change in the policy list

Related policy hubs

New Jersey Medicaid policiesNJ policy changesOrthopedicsPodiatryPhysical TherapyOccupational TherapyPM&R (Physical Medicine & Rehab)Code L3010Code L3020Code L3030Code L3070Code L3080Code L3090Code L5200Code L5210Code L5220

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