MedicaidBilling CodesMedium impact
Newsletter Vol. 8, No. 19
New Jersey Medicaid·NJ · OB-GYN, General Surgery·Eligibility
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid has updated specific HCPCS codes and fee allowances for abortion-related procedures billed on a fee-for-service basis. The policy clarifies billing procedures for ultrasounds, surgical pathology, RhoGam injections, and other services related to elective abortions for Medicaid and NJ KidCare beneficiaries.
Action Required
Immediately: Billing team must update fee schedules for abortion-related procedures with new maximum allowances. Use specific HCPCS codes with YD modifiers when billing for elective abortion services for New Jersey Medicaid and NJ KidCare beneficiaries. Providers previously denied for these services may resubmit claims if timely filing requirements are met.