MedicaidAdministrativeHigh impact
Newsletter Vol. 2, No. 41
New Jersey Medicaid·NJ·Provider Notice
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid requires all providers to submit hardcopy claims using ONLY the NJ version of the claim form, not the federal HCFA version. Claims submitted on the federal HCFA form will be rejected and returned to the provider for resubmission on the NJ form. This applies immediately to all Medicaid and Medicare-Medicaid crossover claims.
Action Required
IMMEDIATELY: Billing team must stop using federal HCFA claim forms for all New Jersey Medicaid submissions and Medicare-Medicaid crossover claims. 1) Verify that all hardcopy claim submissions use ONLY the NJ version of the claim form. 2) Update billing procedures and staff training to document this requirement. 3) If any claims are returned due to HCFA form usage, resubmit immediately on NJ form. 4) Contact the NJ Medicaid Management Information System (NJMMIS) at https://www.njmmis.com if clarification is needed on which form version is required. Failure to comply will result in claim rejections and payment delays.