MedicaidAdministrativeHigh impact
Newsletter Vol. 3, No. 18
New Jersey Medicaid·NJ·Provider Notice
Effective date
Jun 1, 2024
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid has updated billing procedures for hospital inpatient claims when patients have both Medicaid and Medicare coverage. For discharges on/before May 2024, hospitals must submit separate UB claim forms for Medicare deductibles/coinsurance versus non-covered charges. For discharges on/after June 2024, hospitals can submit one consolidated UB claim form with specific field requirements.
Action Required
Immediately: Hospital billing teams must implement dual billing procedures based on discharge dates. For discharges before June 1, 2024: Submit separate UB claim forms - one for Medicare deductibles/coinsurance (using Condition Code 21) and another for non-covered charges. For discharges on/after June 1, 2024: Submit single UB claim form with total charges in Field 47, covered charges by payer in Fields 48a-d, and prior payments in Fields 50a-c. Update billing system workflows to automatically route claims based on discharge date. For claims with more than three payers, complete second UB form and staple together with required attachments.