MedicaidReimbursementHigh impact
Newsletter Vol. 32, No.07
New Jersey Medicaid·NJ · Family Medicine, Internal Medicine, OB-GYN +3 more·Provider Notice
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid has clarified reimbursement rules for physician and outpatient-administered drugs, including LARC devices. Providers must now bill their actual drug acquisition cost as the submitted charge, and use modifier 'U8' when billing 340B drugs or LARC devices.
Action Required
Immediately: Billing team must update procedures to bill actual drug acquisition cost (not AWP or other pricing) as the submitted charge for all physician and outpatient-administered drugs. Add modifier 'U8' to all 340B drugs and LARC devices when using HCPCS codes J0120-J9999 and other specified codes. Update billing software to reflect 340B acquisition pricing in charge field for 340B inventory drugs.