MedicaidCoverageMedium impact
Newsletter Vol. 36, No.06
New Jersey Medicaid·NJ · Psychiatry, Pediatrics, Internal Medicine +1 more·Provider Notice
Effective date
Jul 1, 2026
We identified it
Aug 4, 2026
Summary
New Jersey Medicaid (NJ FamilyCare) now covers EPSDT evaluations and targeted case management services for incarcerated juveniles and former foster youth aged 21-26 within 30 days pre- and post-release from incarceration. Billing teams must implement new CPT codes with specific modifiers (QJU1, QJU2, QJU3) for EPSDT evaluations and use T1017EP for targeted case management services. Providers must enroll designated staff as Juvenile Re-Entry Case Managers and obtain NPIs.
Action Required
By June 30, 2026: (1) Billing team must update billing system to recognize new CPT codes 99384 and 99385 with modifiers QJU1, QJU2, and QJU3 for EPSDT evaluations (age-stratified: 12-17 years vs. 18-26 years) and T1017EP for targeted case management services. (2) Youth Justice Commission (YJC) employed providers and Division of Mental Health and Addiction Services contracted Integrated Case Management (ICMS) providers must enroll designated re-entry staff as Juvenile Re-Entry Case Managers via www.njmmis.com provider enrollment application. (3) Each enrolling provider must obtain a National Provider Identifier (NPI) at https://nppes.cms.hhs.gov (allow 10 days for processing). (4) Providers must establish billing workflows distinguishing pre-release services (EPSDT evaluation + TCM billable as listed codes) from post-release services (30 days post-release, TCM + any covered Medicaid/NJ FamilyCare services per standard billing codes). (5) Configure encounter forms and documentation templates to capture EPSDT evaluation intensity level (low/moderate/high) and service delivery method (in-person, telephonic, or video). Failure to enroll and obtain NPIs will prevent claims from processing. Claims submitted without proper modifiers or from non-enrolled providers will be denied.