New jersey medicaid fee schedule. 19-B 24-0001, which was submitted to CMS on March 27, 2024.

New jersey medicaid fee schedule 69 39. 10:58A-1. Jan 4, 2013 · Home > Insurance Division > PIP Information for Health Care Providers PIP Information for Health Care Providers Find information regarding Dec 18, 2000 · Except for the schedule of nursing and allied professional health services, which remains in effect as Appendix, Exhibit 3, the existing fee schedules set forth at N. By expanding coverage, streamlining access, and emphasizing in-network care, the initiative addresses critical gaps in mental health and substance use disorder treatment. Jan 3, 2025 · New Jersey Medicaid’s 2025 behavioral health services update is a transformative step towards enhancing the well-being of NJ FamilyCare members. 72 40. 53 99212 OFFIC/OUTPT VISIT E&M EST SELF-LIMIT/MINOR 10MIN36. 11:3-29. Fee for Service Revisions (SFY 17-18) Payer of last resort: Provides guidance on choosing payer source for clients in accordance with state and federal funding regulations: NJ Family Care/Medicaid Reimbursement for Services Rendered (Payor of Last Except as otherwise noted in the plan, state-developed fee schedule rates are the same for both governmental and private providers of the Medicaid services listed below. Federally Qualified Health Centers (FQHC) Reimbursement TAKE NOTICE the New Jersey Department of Human Services (DHS), Division of Medical Assistance and Health Services (DMAHS) intends to seek approval from the United States Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), for amendments to the New Jersey Medicaid (Title XIX) State Plan in order Introduction Beginning January 1, 2017, the New Jersey Department of Human Services (DHS), Division of Mental Health and Addiction Services (DMHAS) instituted a new approach to funding certain community-based mental health services, known as the Mental Health Fee-for-Service Program (“MH FFS Program”). The fee schedule is based on a unit of service and will be published on the Department of Human Services’ Division of Medical Assistance and Health Services’ fiscal agent’s website at https://www. The list contains the fee schedule amounts, floors, and ceilings for all procedure codes and payment category, jurisdication, and short description assigned to each procedure code. New Jersey Medicaid Telehealth Services Billing & Coding Cheat Sheet The Department of Human Services, Division of Medical Assistance and Health Services is directing the Medicaid Managed Care Organizations and the Medicaid Fee for Service Program that MCOs and Medicaid/NJ FamilyCare will: Hospice Reimbursement TAKE NOTICE that the New Jersey Department of Human Services (DHS), Division of Medical Assistance and Health Services (DMAHS) intends to seek approval from the United States Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), for amendments to the New Jersey Medicaid (Title XIX) State Plan, in order to clarify the State Plan . 19-B below were set on January 1, 2022 and are effective for services provided on or after that date. FEE SCHEDULE EFFECTIVE DATES AND LINKS Except where noted otherwise, the fees in the State’s fee schedules referenced in Attachment 4. 84 28. Except as otherwise noted in the plan, state-developed fee schedule rates are the same for both governmental and private providers of the Medicaid services Although PACT, ICMS, and CSS are Medicaid-covered services, New Jersey Medicaid rules generally prohibit payment to such providers for services provided to consumers during periods of admission to an inpatient setting or incarceration. The MH FFS Program pays provider agencies under contract with the DMHAS to deliver Welcome to New Jersey Medicaid: Document Download NJMMIS_3 Dec 24, 2024 · New Jersey State Publications Digital Library Human Services Medical Assistance and Health Services, Division of Medicaid Communications 2025 Income and Resource Standards for Medicaid Only; 2025 Rates for Home and Community Based Services New: Building on the State-funded Substance Use Disorder Promoting Interoperability Program (SUD PIP) and expanding support to a broader group of behavioral health providers, New Jersey Division of Medical Assistance and Health Services (NJ DMAHS) in collaboration with the Division of Mental Health and Addiction Services (NJ DMHAS) launched the Jan 1, 2024 · 2024 carrier priced Medicare Part B fee schedule downloads These carrier / contractor-priced Medicare fee schedule amounts are for Delaware, District of Columbia (DC), Maryland (MD), New Jersey (NJ), and Pennsylvania (PA), and they are subject to change. 32 99205 OFFIC/OUTPT VISIT E&M NEW MOD-HI SEVERITY 60 MIN150. We are Concerning Medicaid fees, many commenters stated that New Jersey’s Medicaid reimbursement rate is one of the lowest in the country and should not be used in developing the fee schedule. Plan First is a NJ FamilyCare Medicaid fee-for-service program providing comprehensive family planning services and certain family planning-related services for both women and men. The Medicaid Managed Care Program, administered by DMAHS, has oversight of the managed care medical assistance program within the New Jersey Department of Human Services (DHS) and administers all Medicaid/NJ FamilyCare Program benefits provided through Aetna Better Health of New Jersey. 1. Those not covered by Medicaid, private insurance or FFS funding will be eligible for a sliding fee scale Source: 2025 Department of Health and Human Services Poverty Guidelines Effective Date: 2/27/2017 1/1/2024 Jun 1, 2019 · Effective Date:June 1, 2019Revision Date:February 27, 2025Policy Last Review Date:February 27, 2025Purpose:This policy provides guidelines for coverage and reimbursement of ambulance services including ground and air ambulance transports. 19-B below were set on January 1 , 2023 and are effective for services provided on or after that date. 6 for physicians’ services, ambulance services and durable medical equipment and prosthetic devices have been repealed and replaced by the schedules found in the New Jersey Medicaid fee schedules are updated quarterly. Please note that the full fee schedule listing contains over 10,000 codes across all specialties in the Horizon Blue Cross Blue Shield of New Jersey Networks and therefore, we recommend that you request the codes for your individual specialty first. This resource includes a compilation of Medicare and Medicaid Fee Schedules. 12 99213 OFFIC/OUTPT VISIT E&M EST LOW-MOD SEVERITY 15MIN46 Keep in mind that determination of coverage under a member's benefit plan does not necessarily ensure reimbursement. If there is a Medicaid/NJ FamilyCare Fee schedule, reimbursement shall be based on the lesser of the provider's usual and customary charge to the general public; or the Medicaid/NJ FamilyCare maximum fee allowance assigned by the Division. This policy applies to participating and non-participating professional providers. Except as otherwise noted in the plan, state-developed fee schedule rates are the same for both governmental and private providers of the Medicaid services FEE SCHEDULE EFFECTIVE DATES AND LINKS Except where noted otherwise, the fees in the State’s fee schedules referenced in Attachment 4. The information below should be considered educational information and should not be considered legal advice. Division of Medical Assistance and Health Services (DMAHS) intends to seek approval from the United States Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), for an amendment to the New Jersey Medicaid (Title XIX) State Plan, in order to implement budget provisions subject to the passage of the New Jersey Fiscal Year 2024 Appropriations Act General Requirements We will pay claims based only on eligible charges. NJ FamilyCare/Medicaid reimbursement for a myriad of behavioral health services is enabled through the Medicaid State Plan and the NJ Comprehensive 1115 Medicaid waiver, enacted in 2012. Except as otherwise noted in the plan, state-developed fee schedule rates are the same for both governmental and private providers of the Medicaid services Codes labeled with an asterisk (*) are not on the State of New Jersey Medicaid Fee Schedule and therefore may not be covered by the State of New Jersey Medicaid Program. This amendment was submitted in order to update the fee rates for 2021 including an increase for certified nurse midwives. Scope:Products included:NJ FamilyCare/Medicaid PlanFully Integrated Dual Eligible Special Needs Plan (FIDE-SNP)Definitions:Ground ambulance transports include DME Procedure Codes and RatesEC001126C The NJ state wide average cost-to-charge ratio is the average cost-to-charge ratio for all NJ acute hospitals based on the prior calendar year’s cost-to-charge ratio. The Department of Human Services’ (DHS) Division of Developmental Disabilities (Division) completed publication of the required Public Notice and Rates on June 30, 2023, allowing the increases to be effective on July 1, 2023. This program is designed to improve access to primary care and specialty care services for Medicaid beneficiaries in light of the expansion of Fee-for-Service Rate Schedule: Quick Reference Guide * Use of Tier and Acuity Differentiated rates are determined through completion of the New Jersey Comprehensive Assessment Tool (NJ CAT) **The "Brick" is the basis for each rate; for actual rates for each service see Page 2; services listed at an hourly rate may actually be billed in 15‐minute increments. Jul 6, 2023 · Topic: FY24 Rate Changes The State Fiscal Year 2024 (FY24) Appropriations Act included language increasing certain Fee-For-Service rates. Find a complete listing of up-to-date Community Plan Reimbursement Policies for UnitedHealthcare Medicare products. Please use the full file downloads (right column on this screen May 23, 2024 · Minimum fee schedules as established by the state for professional services provided by qualified providers affiliated with schools of medicine or dentistry who participate in the New Jersey Medicaid program for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a risk-based rate adjustment INSERT TISSUE EXPANDER(S) Division of Medical Assistance and Health Services (DMAHS) intends to seek approval from the United States Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), for an amendment to the New Jersey Medicaid (Title XIX) State Plan, in order to reflect that New Jersey Medicaid fee-for-service rates for State Plan services across all benefit categories FEE SCHEDULE EFFECTIVE DATES AND LINKS Except where noted otherwise, the fees in the State’s fee schedules referenced in Attachment 4. xlsFee Schedule for Durable Medical Equipment, Prosthetics, Orthotics & Supplies The Horizon Behavioral Health℠ program supports our members in getting access to safe and effective mental health and Substance Use Disorder care. Except as otherwise noted in the plan, state-developed fee schedule rates are the same for both governmental and private providers of the Medicaid services TAKE NOTICE that the New Jersey Department of Human Services (DHS), Division of Medical Assistance and Health Services (DMAHS) intends to seek approval from the United States Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), for an amendment to the New Jersey Medicaid (Title XIX) State Plan, in Jul 1, 2024 · • Minimum fee schedules as established by the state for professional services provided by qualified providers affiliated with schools of medicine or dentistry who participate in the New Jersey Medicaid program for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a risk-based rate adjustment. 30 154. FEE SCHEDULE EFFECTIVE DATES AND LINKS The fees in the State’s fee schedules referenced in Attachment 4. Services for both ABP and Although PACT, ICMS, and CSS are Medicaid-covered services, New Jersey Medicaid rules generally prohibit payment to such providers for services provided to consumers during periods of admission to an inpatient setting or incarceration. Division of Medical Assistance and Health Services (DMAHS) intends to seek approval from the United States Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), for an amendment to the New Jersey Medicaid (Title XIX) State Plan, in order to reflect that New Jersey Medicaid fee-for-service rates for State Plan services across all benefit categories Fee For Service Network Revisions for SFY17-18 Information regarding the codes and the rate changes for SUD FFS Initatives implemented in July 2016. Members have full access to the fee schedules and can request additional codes and updates, along with any therapy compliance or billing issues. Purpose and scope This chapter outlines the policies and procedures for coverage of clinical laboratory services that must be met in order to qualify for reimbursement under the Medicaid/NJ FamilyCare fee-for-service programs. 19-B below were set on January 1, 2025 and are effective for services provided on or after that date. This comprehensive listing of fee maximums is used to reimburse a physician and/or other providers on a fee-for-service basis. Except as otherwise noted in the plan, state-developed fee schedule rates are the same for both governmental and private providers of the Medicaid services TAKE NOTICE the New Jersey Department of Human Services (DHS), Division of Medical Assistance and Health Services (DMAHS) intends to seek approval from the United States Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), for the following amendments to the New Jersey Medicaid (Title XIX) State Plan Jul 25, 2022 · In New Jersey, most behavioral health services for Medicaid patients are reimbursed by NJ FamilyCare–New Jersey’s Medicaid. This plan amendment updates Fee-for Service rate schedules across benefit categories. 1, 2023 New Jersey Fidelis Care Plan Rebranding FAQs 3-Day Payment Window - CC. The estimated impact of the amendment is anticipated to be $38M for SFY2025 ($22M state funds and $16M Federal funds). This category of waivers allows states to provide patients with services The Medicaid Only program is administered by the county welfare agencies (CWAs) of the State of New Jersey through the Division of Medical Assistance and Health Services in the Department of Human Services. A. 500 Allergy Testing and Therapy (More Restrictive) NJ CAID/CARE EVV Provider Training Presentation (PDF) Termination of Somatus Care Management Program for Patients with CKD/ESRD Nov 16, 2022 · Medicaid Covered Outpatient Prescription Drug Reimbursement Information by StateQuarter Ending September 2022View cost sharing and copayment information. Our goal is for our members to get the right care, in the right setting, when they need it. In other cases, a state Medicaid program will accept a provider’s Medicaid enrollment in the state where the provider practices. PP. Physician Fee Schedule: CY 2026 Final Rule – Learn What's New CMS issued the CY 2026 Physician Fee Schedule (PFS) final rule that announces final policy changes for Medicare payments under the PFS and other Medicare Part B issues. Except as otherwise noted in the plan, state-developed fee schedule rates are the same for both governmental and private providers of the Medicaid services Nursing facilities nationwide currently facing moderate to high levels of staffing shortages New Jersey LTC Program Assessment: 2022 24k Number of New Jersey residents in NFs whose primary payer is Medicaid, CY 2020 97% Medicaid NF residents enrolled in MLTSS program as of September 2021 Key Points Jan 1, 2025 · NJ-25-0001 This amendment provides the states' annual rate increases across all benefit categories with an effective date of January 1, 2025. J. Except as otherwise noted in the plan, state-developed fee schedule rates are the same for both governmental and private providers of the Medicaid services Exhibit 5 DME Fee Schedule. Except as otherwise noted in the plan, state-developed fee schedule rates are the same for both governmental and private providers of the Medicaid services Appendix Exhibit 4AMBULANCE SERVICES FEE SCHEDULE Jan 1, 2025 · Providers in DC, DE, MD, NJ & PA JL Home &#9658 Fee Schedules &#9658 Ambulatory Surgical Center (ASC) Fee Schedule - 2025 Contribute Print Aug 1, 2023 · WellCare of New Jersey will become Fidelis Care on Aug. The program ensures medical and behavioral health services are available to help members better manage their overall health. Mar 26, 1997 · UTILIZATION MANAGEMENT POLICY Durable Medical Equipment (DME) and Medical Supplies, Orthotics, and Prosthetics EFFECTIVE DATE March 26, 1997 LAST REVIEWED DATE August 13, 2025 PURPOSE Define the level of benefits and process to access DME, Medical Supplies, Orthotics and Prosthetics. Unless the provider contract states otherwise, claims will be paid on the lesser of billed charges or the contracted rate (fee schedule). 19-B below were set on January 1, 2023 and are effective for services provided on or after that date. Quarterly downloads (April Jan 1, 2025 · Community Plan of New Jersey Reimbursement Policies are based on national and state reimbursement determinations, policies and requirements. Scope of Manual: This document provides a detailed description of New Jersey’s implementation of the NJ Medicaid Access to Physician Services (MAPS) Program for Managed Care, as well as Fee-for- Service payments within the New Jersey Medicaid program. 19-B below were set on January 1, 2024 and are effective for services provided on or after that date. 44 120. These policies may be superseded by state, federal or Centers for Medicare & Medicaid Services (CMS) requirements. Consistent with CFR 42 Part § 447. 3, Provider participation) shall be reimbursed on a fee-for-service basis in accordance with N. 45: the We have reviewed the proposed amendment to Attachment 4. Medicaid Reimbursement and Billing Claims for all Horizon NJ Health Medicaid members should be submitted to your local BCBS Plan. Services for both ABP Fee-for-Service Rate Schedule: Quick Reference Guide * Use of Tier and Acuity Differentiated rates are determined through completion of the New Jersey Comprehensive Assessment Tool (NJ CAT) Sep 11, 2024 · Effective Date: September 11, 2024 Revision Date: May 22, 2025 Policy Last Review Date: May 22, 2025 Purpose: To provide guidelines for billing Applied Behavior Analysis (ABA) in the treatment of Autism Spectrum Disorder. Except as otherwise noted in the plan, state-developed fee schedule rates are the same for both governmental and private providers of the Medicaid services 2025-2026 Medicaid Managed Care Rate Development Guide In August 2025, CMS released the 2025-2026 Medicaid Managed Care Rate Development Guide for states to use when setting capitation rates with respect to any managed care program subject to federal actuarial soundness requirements during rating periods starting between July 1, 2025, and June FEE SCHEDULE EFFECTIVE DATES AND LINKS Except where noted otherwise, the fees in the State's fee schedules referenced in Attachment 4. Copyright © 2017, State of New Jersey New Jersey Department of Banking and Insurance This page brought to you by the Insurance Division and the Office of Public Affairs Plan First is New Jersey's new Family Planning program open to enrollment on or after October 1, 2019. Except as otherwise noted in the plan, state-developed fee schedule rates are the same for both governmental and private providers of the Medicaid services Scope of Manual: This document provides a detailed description of New Jersey’s implementation of the NJ Medicaid Access to Physician Services (MAPS) Program for Managed Care as well as Fee-for- Service payments within the New Jersey Medicaid program. Reimbursement shall be limited to payment for medically necessary covered services provided within the appropriate scope of practice in accordance with the individual category of certification for The federal Centers for Medicare & Medicaid Services (CMS) approved the NJ Medicaid agency’s fee schedule on January 13, 2025 to pay providers to deliver Housing Support Program services. Client is determined to be eligible for FFS funding (138% to 350% of FPL). 19-B of your Medicaid State plan submitted under transmittal number 21-0002. 19-B were set on January 1,2020 and are effective for services provided on or after that date. New: Building on the State-funded Substance Use Disorder Promoting Interoperability Program (SUD PIP) and expanding support to a broader group of behavioral health providers, New Jersey Division of Medical Assistance and Health Services (NJ DMAHS) in collaboration with the Division of Mental Health and Addiction Services (NJ DMHAS) launched the NJ Medicaid & Managed Care In 1995, New Jersey began moving Medicaid beneficiaries from a traditional fee-for-service health coverage program, where providers bill Medicaid directly, to managed care. com under “rate and code information”, when available. 44 163. BRACHYTHERAPY SOURCE, NON-STRA Scope of Manual: This document provides a detailed description of New Jersey’s implementation of the NJ Medicaid Access to Physician Services (MAPS) Program for Managed Care as well as Fee-for-Service payments within the New Jersey Medicaid program. Impacted rates are as follows: (b) An approved New Jersey Medicaid/NJ FamilyCare APN provider (see N. SCOPE AND APPLICABILITY SCOPE: This policy applies to utilization management review of requests for DME for The general information and procedures set forth in these instructions will enable providers to submit correct and accurate fee-for-service claims for services performed under the Medicaid/NJ FamilyCare Program and other applicable New Jersey Medical and Pharmaceutical Assistance Programs. Providers and facilities are required to use industry standard codes for claim submissions. Except as otherwise noted in the plan, state-developed fee schedule rates are the same for both governmental and private providers of the Medicaid services listed below. This document describes the rates that the state will pay providers to deliver pre-tenancy and tenancy sustaining services. 19-B 24-0001, which was submitted to CMS on March 27, 2024. Exhibit 5 Durable Medical Equipment Fees. 96 114. This program is designed to improve access to primary care and specialty care services for Medicaid beneficiaries in light of the expansion of 2 days ago · NOTE: Data for individual code searches for 2025 dates of service are not yet available in the system. To meet the needs of New Jersey’s Medicaid population, NJ FamilyCare has expanded existing ASD services to offer a wider array of services designed to offer a combination of therapies, each targeting different set of skills that will support a child’s development. 33 99211 OFFIC/OUTPT VISIT E&M ESTAB NO PHYS PRES 5 MIN25. FEE SCHEDULE EFFECTIVE DA TES AND LINKS Except where noted otherwise, the fees in the State's fee schedules referenced in Attachment 4. CPT Mod Description Region 1 Region 2 Region 3 99204 OFFIC/OUTPT VISIT E&M NEW MOD-HI SEVERITY 45 MIN111. Approved Vendor ListBilling Supplements / Training PacketsRecent NewslettersEdit CodesFAQForms & DocumentsPhysician Administered Drugs (UOM)Rate and Code InformationNewsletters & AlertsNJ State MACOver The Counter(OTC) Benefits Division of Medical Assistance and Health Services (DMAHS) intends to seek approval from the United States Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), for an amendment to the New Jersey Medicaid (Title XIX) State Plan, in order to reflect that New Jersey Medicaid fee-for-service rates for State Plan services across all benefit categories Jan 1, 2025 · In alignment with these goals, beginning January 1, 2025, Fidelis Care New Jersey Medicaid/NJ FamilyCare Plan providers who are not part of the Fidelis Care New Jersey Medicaid/NJ FamilyCare network will receive reimbursement based on the payor's fee schedule. Submission of error-free claims will result in prompt processing of claims for services rendered The Frequently Asked Questions (FAQs) document addresses general transition, contracting, rates and Medicaid questions and substance use disorder and mental health program specific questions: Fee for Service (June 2016) Mental Health Fee for Service (February 2017) 2. The services of a qualified clinical laboratory for which reimbursement may be made relate only to diagnostic tests performed in a laboratory which is FEE SCHEDULE EFFECTIVE DATES AND LINKS Except where noted otherwise, the fees in the State’s fee schedules referenced in Attachment 4. of Medical Assistance and Health Services (DMAHS) intends to seek approval from the United States Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), for any required amendments to the New Jersey Medicaid (Title XIX) State Plan in order to implement the following subject to the passage of the State Fiscal Year 2024 (SFY24) Appropriations Act. Resources New Jersey State regulations, manuals & fee schedules American Medical Association, Current Procedural Terminology (CPT®) Professional Edition and associated publications and services Centers for Medicare and Medicaid Services, CMS Manual System and other CMS publications and services Mar 14, 2024 · The requirements of the bill will apply to services reimbursed under both the Medicaid fee-for-service delivery system and the Medicaid managed care delivery system, and to services delivered by an approved Medicaid provider. 63 27. lth conditions for Medicaid recipients under the age of twenty-one. The 2024 Medicare fee schedule contains the rates that were installed January 1, 2024, unless otherwise noted. xls Effective April 1, 2020, NJ FamilyCare Medicaid will reimburse Medicaid-enrolled Applied Behavior Analysis (ABA) therapy providers for Autism Spectrum Disorder (ASD) treatment services, including behavior identification assessments, supporting assessments, adaptive behavior treatment, individual and group, and family adaptive behavior treatment. This program is designed to improve access to primary care and specialty care services for Medicaid beneficiaries in light of the expansion of Mar 1, 2024 · Horizon NJ Health is updating our fee schedule for behavioral health services to more closely align with the Behavioral Health Rate Increase announced in the Division of Medical Assistance & Health Services’ (DMAHS) Medicaid Alert, dated August 2023 and the rate and code information accessible through NJMMIS. Feb 1, 2022 · Division of Medical Assistance and Health Services (DMAHS) intends to seek approval from the United States Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), for an amendment to the New Jersey Medicaid (Title XIX) State Plan, increasing New Jersey Medicaid fee-for-service rates for adaptive behavior treatment by a Behavior Technician (BT) to 2 days ago · Providers in AR, CO, LA, MS, NM, OK, TX, Indian Health & Veteran Affairs JH Home Print Contribute AOA’s practice success resources were developed by AOA to help doctors of optometry address common issues in practice. njmmis. See a summary of key provisions effective on or after January 1, 2026. 19-B were set on January 1, 2020 and are effective for services provided on or after that date. May 27, 2022 · A fee schedule is a complete listing of fees used by Medicare to pay doctors or other providers/suppliers. Evaluation and Management Services billed with Global Radiology, Stress Test, Stress Echo or Myocardial Profusion Imaging Service Partial Care, Co-Occurring Capable (hour) Partial Hospital (hour) Mar 25, 2021 · You may request the top 100 billed codes related to your specialty or the full fee schedule listing by checking one of the boxes below. Nov 6, 2017 · Information about the transition to a fee for service model at the NJ Division of Mental Health and Addiction Services FEE SCHEDULE EFFECTIVE DATES AND LINKS Except where noted otherwise, the fees in the State’s fee schedules referenced in Attachment 4. The Centers for Medicare & Medicaid Services (CMS) has reviewed the proposed New Jersey state plan amendment (SPA) to Attachment 4. C. Based upon the information provided by New Jersey, we have approved the amendment with an effective date of January 1, 2021. Claims submitted by nonparticipating providers will be paid on the lesser of billed charges or the nonparticipating provider fee schedule. 10:58A-4. Horizon NJ Health shall reimburse eligible claims for ABA services for members under the § 10:61-1. tvmbdy bzji bbee pyio fqxxmymn ivyt aeouv ngvwi hpzxam xbepm oxjh liafp jewgb bhkmxaaha swtyr