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 effective April 1, 2026 for New Jersey FamilyCare (Medicaid) members. Healthcare providers can perform assessments using specific HCPCS codes, but enrollment in the CBPC network is required to offer the PMPM bundle and prevent claim denials.
Action Required
Immediately: Providers interested in offering palliative care services must enroll in the CBPC network through UnitedHealthcare to prevent claim denials. Update billing system to use codes S0280 ($100) for initial assessments, S0311 ($696 PMPM bundle - requires prior auth), and S0281 ($85) for reassessments. Billing team must ensure prior authorization is obtained for S0311 and document care coordination activities for audit purposes.
Affected Billing Codes
Plan Types
Medicaid
States
NJ
Specialties
palliative-care, oncology, family-medicine, internal-medicine