MedicaidPrior AuthMedium impact
Newsletter Vol. 8, No. 72
New Jersey Medicaid·NJ · Psychiatry·Prior Authorization
Effective date
Jan 1, 1999
We identified it
Jun 20, 2026
Summary
New Jersey is changing prior authorization procedures for mental health services effective January 1, 1999. PA requests must now be submitted to designated Medicaid District Offices based on provider county location instead of the OHSA office, and a new system edit will monitor the $6,000 PA threshold requirement.
Action Required
Before January 1, 1999: Mental health providers in New Jersey must identify their assigned Medicaid District Office based on county location and submit all prior authorization requests using forms FD-07 and FD-07A to the correct MDO instead of OHSA. Update internal procedures to track the $6,000 threshold per beneficiary per 12-month period as Edit 763 will monitor compliance. Failure to obtain required PA will result in claim denials or recoupment.