MedicaidReimbursementHigh impact
Newsletter Vol. 2, No. 08
New Jersey Medicaid·NJ·Coding
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid has released an interim Maximum Fee Allowance Schedule for HCPCS codes related to Durable Medical Equipment and Medical Supplies, effective immediately during the transition to UnisysParamax as the new fiscal agent. Billing teams must apply appropriate modifier codes to HCPCS procedure codes to avoid claim processing delays, and providers may request fee adjustments if costs exceed allowances by submitting supporting documentation.
Action Required
Immediately: Billing team must obtain and implement the interim Maximum Fee Allowance Schedule for HCPCS procedure codes from the attached policy document. Update billing software to require appropriate modifier codes (per the Introduction section of the attachment) be appended to all HCPCS codes for Durable Medical Equipment and Medical Supplies claims submitted to UnisysParamax. For any claims where provider costs exceed the interim fee allowances, prepare MMIS Claim Adjustment Request Form FD with supporting invoices or price lists and submit to UnisysParamax. Train all billing and claims staff that failure to add correct modifier codes will delay claim processing. Establish a system to track and inquire about paid or denied claims within 30 days of the Remittance Advice Statement date as indicated. Update the Medical Supplier Services Manual to reference Subchapter HCPCS Rev. (replacing prior Rev.) for ongoing reference.