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MedicaidCoverageMedium impact

New Jersey Medicaid: Discover new program for serious illness care

UnitedHealthcare·NJ · Palliative Care, Family Medicine, Internal Medicine +1 more·State news
Effective date
Apr 1, 2026
We identified it
Jun 13, 2026
Days to comply

Summary

UnitedHealthcare Community Plan of New Jersey launched a new Community-Based Palliative Care (CBPC) program for New Jersey FamilyCare members effective April 1, 2026. Healthcare professionals can perform assessments using new HCPCS codes, but must enroll in the CBPC network to offer the PMPM bundle service to prevent claim denials.

Action Required

Action needed
Immediately: Providers interested in offering palliative care services must enroll in the UnitedHealthcare CBPC network to prevent claim denials for HCPCS codes S0280, S0311, and S0281. Update billing system to require prior authorization for S0311 (PMPM bundle). Train billing staff on new denial codes and ensure comprehensive medical assessment tools are submitted to MCO for S0280 and S0281 services.

Affected Billing Codes

S0280
S0311
S0281
New Jersey Medicaid: Discover new program for serious illness care | UnitedHealthcare | PolicyChanges.app