MedicaidPrior AuthMedium impact
Newsletter Vol. 2, No. 60
New Jersey Medicaid·NJ · Palliative Care·Prior Authorization
Effective date
Nov 1, 2024
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid has eliminated the prior authorization requirement for hospice services provided to Medicaid recipients under the AIDS Community Care Alternatives Program (ACCAP), effective November 1. Hospice agencies no longer need to submit prior authorization forms to the Medicaid District Office, and prior authorization numbers are not required on claims for HCPCS procedure code G0152 (Hospice daily).
Action Required
By November 1: Billing team must update billing system to remove prior authorization requirements for HCPCS code G0152 (Hospice daily) for New Jersey Medicaid ACCAP patients. Remove prior authorization number field requirements on NJ claim forms for this code. Hospice agencies must still contact the patient's ACCAP case manager before initiating services to confirm services fit within the service plan and cost cap.