New Jersey Medicaid: Discover new program for serious illness care
AI Summary
UnitedHealthcare Community Plan of New Jersey launched a new Community-Based Palliative Care (CBPC) program for New Jersey FamilyCare (Medicaid) members effective April 1, 2026. Healthcare professionals can perform assessments using new HCPCS codes, but must enroll in the CBPC network to bill the PMPM bundle service to avoid claim denials.
Action Required
Immediately: Providers interested in offering palliative care services must enroll in the CBPC network through UnitedHealthcare to bill S0311 PMPM bundle services. Update billing system to recognize new HCPCS codes S0280 ($100), S0311 ($696 - requires prior auth), and S0281 ($85). Train staff that S0311 requires prior authorization while S0280 and S0281 do not. Failure to enroll in CBPC network will result in claim denials for palliative care services.
Affected Billing Codes
Plan Types
Medicaid
States
NJ
Specialties
palliative-care, family-medicine, internal-medicine, oncology