MedicaidReimbursementMedium impact
Newsletter Vol. 4, No. 20
New Jersey Medicaid·NJ·Reimbursement
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid has established an administrative patient day rate for hospitalized Medicaid recipients awaiting nursing facility placement who require nursing facility level of care. The rate is based on the statewide weighted average per diem rate for SNF and ICF facilities. Hospitals must apply this rate to all identified SNF/ICF patient days reported on claims effective January.
Action Required
By January 2024: Billing team must update claims processing workflow to identify and flag patient days meeting nursing facility level of care criteria for Medicaid beneficiaries awaiting NF placement. Configure billing system to apply the administrative patient day rate (specific dollar amount not provided in this excerpt) to SNF and ICF days reported on hospital claims. Verify with Finance and Accounting offices that rate tables are current. Contact Felix Almanzor at the New Jersey Division of Medical Assistance and Health Services to confirm the exact reimbursement rate amount if not already distributed. Failure to apply the correct rate will result in underpayment or claim adjustment.