MedicaidAdministrativeHigh impact
Newsletter Vol. 3, No. 48
New Jersey Medicaid·NJ·Provider Notice
We identified it
Jun 20, 2026
Summary
New Jersey hospitals not reimbursed under Medicaid DRG methodology must now bill therapeutic leave days as residential days using Accommodation Revenue Code. Hospitals can submit claims for entire stays or portions of stays that include therapeutic leave days without preparing separate discharge/readmission claim forms.
Action Required
Immediately: Billing team must update claim submission procedures for all New Jersey hospital inpatient Medicaid claims. (1) Train billing staff to identify therapeutic leave days within patient stays. (2) Modify billing system to report therapeutic leave days as residential days in the designated field using Accommodation Revenue Code. (3) Ensure the number of residential days (therapeutic leave days) equals the number of noncovered days entered in the corresponding field. (4) Update billing workflows to allow single claim submissions for stays that include therapeutic leave days—do NOT submit separate discharge and readmission claims. (5) Contact Jeffrey Campbell (Administrative Analyst I, Bureau of Institutional and Provider Reimbursement) with questions. Failure to comply will result in claim denials and improper reimbursement for affected stays.