MedicaidReimbursementMedium impact
Newsletter Vol. 3, No. 48
New Jersey Medicaid·NJ · Emergency Medicine, Critical Care, Anesthesiology·Provider Notice
We identified it
Jun 20, 2026
Summary
New Jersey hospitals are excluded from the New Jersey Medicaid DRG (Diagnosis-Related Group) reimbursement methodology. This policy clarification affects how New Jersey Medicaid processes hospital claims and may impact billing practices for hospital-based services.
Action Required
Immediately: Billing teams working with New Jersey hospitals should verify current Medicaid reimbursement methodology being used instead of DRG rates. Contact New Jersey Medicaid or review updated fee schedules to understand alternative payment structure for hospital claims.