UnitedHealthcareMedium ImpactPrior Auth

New Jersey Medicaid: Billing guidance for sickle cell disease treatments

Published June 3, 2026

AI Summary

New Jersey Medicaid now participates in the Cell and Gene Therapy (CGT) Access Model, providing Medicaid enrollees with sickle cell disease access to cell and gene therapies at reduced costs. Providers must follow new billing guidance for sickle cell disease gene therapies including specific prior authorization requirements and claim submission procedures.

Action Required

Immediately: Billing team must review the 'Billing guidance for Sickle Cell Disease (SCD) gene therapies' document to understand new provider requirements, applicable drugs for treatment, prior authorization requirements, and claim submission procedures for New Jersey Medicaid patients with sickle cell disease. Update billing workflows to ensure compliance with CGT Access Model requirements.

Plan Types

Medicaid

States

NJ

Specialties

hematology, oncology, internal-medicine, pediatrics