All PlansPrior AuthMedium impact
Newsletter Vol. 4, No. 37
New Jersey Medicaid·NJ · Psychiatry·Prior Authorization
We identified it
Jun 20, 2026
Summary
New prior authorization requirements have been implemented for Partial Hospitalization and Partial Care Services. Healthcare practices must now obtain prior authorization before providing these intensive outpatient mental health services to ensure coverage and avoid claim denials.
Action Required
Immediately: Billing team and providers must implement prior authorization requests for all Partial Hospitalization and Partial Care Services before scheduling or providing treatment. Update intake procedures to verify authorization requirements. Contact insurance plans to obtain prior auth before services begin to prevent claim denials.