MedicaidCoverageMedium impact
New Jersey Medicaid: Billing guidance for sickle cell disease treatments
UnitedHealthcare·NJ · Hematology, Oncology, Pediatrics·State news
We identified it
Jan 12, 2026
Summary
New Jersey Medicaid now participates in the CMS Cell and Gene Therapy (CGT) Access Model, providing reduced-cost access to cell and gene therapies for sickle cell disease patients. Specific billing guidance, prior authorization requirements, and claim submission procedures are now in effect for these treatments.
Action Required
Immediately: Review the New Jersey Medicaid billing guidance for Sickle Cell Disease gene therapies to understand applicable drugs, prior authorization requirements, and claim submission procedures. Billing teams treating sickle cell disease patients on New Jersey Medicaid must familiarize themselves with CGT model requirements and update workflows accordingly.