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2025
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- September 4, 2025: : Provider Network Update (PDF)
- August 21, 2025: New Policy Updates: Clinical Payment, Coding and Policy Changes (PDF)
- August 20, 2025: CLIA Certificate Editing (PDF)
- August 18, 2025: New Policy Update: Clinical Payment, Coding and Policy Changes (PDF)
- July 25, 2025: MH Partial Care (PC) and PC Transportation (PDF)
- July 1, 2025: Physician-administered drug claim submission requirements reminder (PDF)
- July 1, 2025: EviCore Prior Authorization Code Requirement (PDF)
- May 22, 2025: Oral Health in Children (PDF)
- May 15, 2025: Summary of EPSDT/PDN Services (PDF)
- May 15, 2025: Criminal Background Screening Policy (PDF)
- March 31, 2025: CXT New State Rule for NJ Medicaid (PDF)
- March 6, 2025: NJ FamilyCare Behavioral Health Integration, Extension of 90-Day Transition Policies (PDF)
- January 27, 2025: NJSAMS Update (PDF)
- January 16, 2025: L5782 CPT Code Update (PDF)
2024
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December 31, 2024: Enhancements to our claims editing programs (PDF)
December 30, 2024: New Policy Update: Clinical Payment, Coding and Policy Changes (PDF)
December 30, 2024: New Policy Update: Clinical Payment, Coding and Policy Changes (PDF)
December 30, 2024: New Policy Update: Clinical Payment, Coding and Policy Changes (PDF)
December 12, 2024: Enhancing claims intake editing for SNIP Types (PDF)
December 12, 2024: Acute Hospital Care at Home Services Policy (PDF)
November 14, 2024: Updates to laboratory codes 81513 & 81514 (PDF)
October 24, 2024: Medicaid Lab NCDs and Precertification Optimization (PDF)
October 22, 2024: Pharmacy Update - Contraceptive Counseling Services (PDF)
October 17, 2024: New Policy Updates: Clinical Payment, Coding and Policy Changes (PDF)
October 11, 2024: Aetna and Quest Analytics Partnership (PDF)
September 30, 2024: New Policy Updates: Clinical Payment, Coding and Policy Changes (PDF)
September 9. 2024: EFT/ERA registration vendor services (PDF)
August 22, 2024: New Policy Updates: Clinical Payment, Coding and Policy Changes (PDF)
July 25, 2024: Reimbursement to Ambulatory Surgical Centers (ASC) For Dental Services (PDF)
July 12, 2024: CLIA Certificate Editing (PDF)
June 19, 2024: Home- and Community-Based Services Loan Redemption Program Webinar (PDF)
June 17, 2024: Genetic codes (PDF)
May 23, 2024: Non-Medically Indicated Early Elective Deliveries Revised Diagnosis Codes (PDF)
April 18, 2024: Medicaid Precertification Optimization (PDF)
April 8, 2024: New Policy Updates: UM Transformation PA Yes (PDF)
April 3, 2024: April 1, 2024: New Policy Updates: NJ RSV Medicaid Provider Notification (PDF)
March 29, 2024: New Policy Updates: Clinical Payment, Coding and Policy Changes (PDF)
March 5, 2024: Non-Medically Indicated Early Elective Deliveries Revised Diagnosis Codes (PDF)
2023
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December 28, 2023: New Policy Update: Clinical Payment, Coding and Policy Changes (PDF)
December 18, 2023: New review process for DRG claims (PDF)
December 1, 2023: UM Transformation Code Additions (PDF)
December 1, 2023: UM Transformation Code Removal (PDF)
October 29, 2023: PPP Community Workgroup (PDF)
October 18, 2023: NJ Medicaid Family Care: Injectable Medication (PDF)
October 13, 2023: Generic Code Testing (PDF)
October 13, 2023: New Policy Update: Clinical Payment, Coding and Policy Changes (PDF)
October 11, 2023: New Jersey & New Jersey LTC Medicaid Notice (PDF)
October 9, 2023: New Policy Updates: Clinical Payment, Coding and Policy Changes (PDF)
October 3, 2023: Peer to Peer Availability Timeline
October 2, 2023: Outpatient Services Prior to Admission (PDF)
September 25, 2023: Urgent determinations (PDF)
September 1, 2023: New Jersey Taxonomy WARN to REJECT (PDF)
August 16, 2023: Centering Youth Mental Health (PDF)
August 15, 2023: DMAHS Provider Training (PDF)
July 17, 2023: Codes Requiring Prior Authorization (PDF)
July 17, 2023: Codes No Longer Requiring Prior Authorization (PDF)June 27, 2023: Policy Update Inpatient Psychiatric Services (PDF)
June 14, 2023: Non-Covered Procedure Codes (PDF)
June 14, 2023: Prior Authorization Code Removal (PDF)
June 5, 2023: New Policy Update - Bundled Services (PDF)
June 5, 2023: New Policy Update - Antepartum Fetal Surveillance (PDF)
June 5, 2023: New Policy Update - Anesthesia for Paint Management (PDF)
May 23, 2023: Medicaid Precertification Optimization (PDF)
March 24, 2023: HRSA Nursing-related funding opportunities (PDF)
March 24, 2023: New Policy Update - Clinical Payment, Coding and Policy Changes (PDF)
March 10, 2023: EFT/ERA Registration Services (EERS)
January 5, 2023: Eviti Recommended Formulary Redirection (PDF)
January 1, 2023: New Policy Updates - Clinical Payment, Coding and Policy Changes (PDF)
2022
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December 8, 2022: New Policy Updates - Clinical Payment, Coding, and Policy Changes (PDF)
October 3, 2022: New P.O. Box Address and Vendor for Paper Claims and Claim Correspondences (PDF)
August 25, 2022: Coding Validation
July 28, 2022: Medicaid Precertification Optimization Code Removal (PDF)
July 8, 2022: Medicaid Precertification Optimization (PDF)
June 29, 2022: DRG validation and Data Mining Reviews (PDF)
June 20, 2022: Policy Updates-Clinical Payment, Coding and Policy Changes
April 19, 2022: Important Medicare Participation Resources for Behavioral Health Providers
2021
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December 20, 2021: PCA Rate Increase Effective 1/1/2022
December 17, 2021: Enhancing Editing Process from SNIP Level 2 to SNIP Level 4
November 23, 2021: Non-participating Provider Reimbursement Policy
November 12, 2021: New Prior Authorization Form Available Soon
September 30, 2021: Update for Peer to Peer Requests
February 15, 2021: Update on using your linked Aetna contract in HHAeXchange
January 6, 2021: Important COVID vaccine update for home care and medical day providers
January 5, 2021: NJ Electronic Visit Verification fact sheet
January 5, 2021: New state mandates effective January 1, 2021
December 14, 2020: Update for PCA Providers on Electronic Visit Verification
December 8. 2020: An Important Reminder About the Use of NPI and Taxonomy Codes
October 28, 2020: DHS Coronavirus Relief Fund - Reimbursement Requests are Due by Nov 13, 2020
October 19, 2020: Notice to Home Health, Personal Care Assisant and Nursing Facility Providers
September 24, 2020: Eviti Connect
September 18, 2020: Prenatal Risk Assessment (PRA)
September 10, 2020: Notice to Personal Care Assistance Providers
August 19, 2020: 21st Century Cures Act Re-issue
August 6, 2020: Notice to Personal Care Assistance Providers
April 1, 2020: We've updated our NJ Medicaid Regulatory Compliance Addendum
July 1, 2019: New Policy Updates - Clinical Payment, Coding and Policy Changes
2020
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December 14, 2020 : Update for PCA providers on electronic visit verification
December 8, 2020: An important reminder about the use of NPA and taxonomy codes
November 25, 2020: New covered benefit for your patients: at-home lead testing
October 19, 2020: Notice to home health, personal care assistant and nursing facility providers
September 24, 2020: Eviti Connect
September 18, 2020: Prenatal Risk Assessment (PRA)
September 10, 2020: Notice to personal care assistance providers
August 19, 2020: 21st Century Cures Act re-issue
August 6, 2020: Notice to personal care assistance providers