MedicaidAdministrativeHigh impact
Newsletter Vol. 2, No. 39
New Jersey Medicaid·NJ·Medical Policy
Effective date
Sep 1, 2024
We identified it
Jun 20, 2026
Summary
Effective September 2024, all New Jersey Medicaid-enrolled facilities performing clinical laboratory testing must have a valid CLIA identification number on file. Reimbursement for laboratory services will not be processed without a CLIA ID, and reference laboratories must be enrolled as New Jersey Medicaid providers with valid CLIA certification.
Action Required
Before September 1, 2024: (1) Billing team must verify that all facilities/entities performing clinical laboratory testing have obtained CLIA identification numbers from HCFA; (2) Complete the CLIA certification form attachment and submit to New Jersey Medicaid Provider Enrollment (Paramax Unisys, CN, Trenton, NJ) before the deadline to ensure the CLIA ID is on file; (3) For reference laboratory billing: Ensure your practice is enrolled as a New Jersey Medicaid provider of service and holds a valid CLIA certificate before submitting laboratory claims; (4) Update billing system validation rules to require CLIA ID verification before processing laboratory claim submissions. Failure to comply will result in claim denials for all laboratory testing performed on or after September 1, 2024. Contact Phyllis Valeri Bruschini, Laboratory Consultant, with questions.