MedicaidBilling CodesHigh impact
Newsletter Vol. 2, No. 61
New Jersey Medicaid·NJ · Pediatrics, Allergy & Immunology, Family Medicine +1 more·Medical Policy
Effective date
Nov 1, 2024
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid expanded Hepatitis B vaccine coverage from high-risk newborns to universal newborn immunization effective immediately. Billing teams must transition from the old generic HCPCS code to nine new manufacturer and age/risk-specific codes, with claims using the old code denied starting November. Providers billing injection-only services must use modifier 26 with the appropriate new codes.
Action Required
By November 1, 2024: Billing team must immediately update billing system to recognize and require eight new HCPCS codes (90723-90730) for Hepatitis B immunization and stop accepting the legacy code for claims. Configure system to deny all claims submitted with the old code on or after November 1. Providers must select the correct code based on vaccine manufacturer (RecombivaxHB or Engerix-B), patient age, and risk status (newborn of HBsAg-negative mother, newborn of HBsAg-positive mother, or high-risk by age group). For injection-only billing without vaccine supply, add modifier 26 to the appropriate code. Update encounter templates and provider billing guidance documents to reflect new code requirements and vaccination schedules. Ensure all staff submitting claims understands the age and risk-status criteria to select correct codes. Note: Claims submitted with dates of service on and after November using the old code will be denied; no retroactive adjustments will be honored.