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Newsletter Vol. 1, No. 03
Act
immediately
Effective date
Nov 1, 1993
Identified
Jun 20, 2026
Summary
New Jersey Medicaid updates billing and prior authorization procedures for medical supplies and durable medical equipment (DME). Providers must use the new FD form for prior authorization requests, submit claims to Unisys using the NJ claim form, and comply with mandatory prior authorization for items costing $500 or more. This policy supersedes previous documentation and is effective immediately.
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What to do
immediately · 11 steps
01Billing team must implement the following changes.
02Obtain and begin using the new FD Form (Medical Supplies and DME Prior Authorization) for all prior authorization requests to the Medicaid District Office (MDO); providers may use the NJ claim form as interim prior auth form until FD supplies arrive.
03Update billing procedures to require mandatory prior authorization for ANY medical supplies, DME rentals, or DME purchases when charges are $500 or more.
04Ensure all claims are submitted to Unisys (CN-Trenton, New Jersey) using the NJ claim form with accurate, detailed completion per the Fiscal Agent Billing Supplement.
05For HCPCS code E (unclassified supplies/equipment): enter E only once on FD or NJ form with a narrative list of all items and prices; attach itemized list and price lists with claim; enter composite charge amount on NJ claim detail line when billing.
06Keep signed FD or NJ authorization documents in recipient files for post-payment audit verification.
07Enter 'Prior Authorization File' in Field 12 (REMARKS) on NJ claim form; do NOT enter prior authorization number in Field 8 (this instruction is deferred).
08For Medicare/Medicaid dual-eligible recipients: use FD or NJ form, bill Medicare as primary, enter 'Medicare/Medicaid Client' in REMARKS field, and attach Medicare EOB with hardcopy claims submitted to Medicaid as secondary.
09Verify Type of Service is coded as 'OTHER' in Field C on claim forms.
10Use appropriate modifiers: N (new equipment), UE (used equipment), R (repair/replace), RR (rental).
11CONSEQUENCES: Claims not properly completed will be returned, suspended, or denied.
Original notice
Newsletter Vol. 1, No. 03
njmmis.com · Always check the source before changing claims.
Related changes
See all New Jersey Medicaid changes →Newsletter Vol. 1, No. 02MediumNo effective date · PharmacyNewsletter Vol. 1, No. 1LowNo effective date · Provider NoticeNewsletter Vol. 1, No. 04MediumNo effective date · Provider NoticeNewsletter Vol. 1, No. 05HighNo effective date · CodingBrowse every New Jersey Medicaid change in the policy list