New Jersey Medicaid (NJ FamilyCare) psychotherapy coverage: codes, prior authorization and who can bill
The short answerAs of April 2025, NJ FamilyCare lets fully licensed LCSWs, LPCs and LMFTs enroll to bill independently, and lists no prior authorization for outpatient psychotherapy codes in its Phase 1 table. Phase 1 behavioral health services are billed to the managed care plans, not fee-for-service.
By Javier Alvarez · Updated · 1 min read
1 row: Medicaid (by state) · New Jersey. Public policy, not the member's benefits.
New Jersey Medicaid (NJ FamilyCare)
NJ FamilyCare Behavioral Health Integration provider guidance (April 2025) and enrollment FAQs (October 2024) · New Jersey
| 90791 | Listed [1] |
|---|---|
| 90832 | Listed [1] |
| 90834 | Listed [1] |
| 90837 | Listed [1] |
| 90846 | Listed [1] |
| 90847 | Listed [1] |
| 90853 | Listed [1] |
| Prior authorization | The packet's Phase 1 table shows prior authorization required: No, for MH evaluation 90791-90792, individual psychotherapy 90832-90839, family therapy 90846-90847 and group therapy 90853. Check the plan for current rules. [1] |
| Who can bill | To bill independently, providers must enroll as an individual and be fully clinically licensed. For behavioral health this includes LCSWs, LPCs and LMFTs. Junior licensed providers (such as LSW or licensed associate MFT) and unlicensed providers cannot bill independently. [1] |
| Managed care plans | Since January 1, 2025, Phase 1 behavioral health services are billed to the managed care plans for all populations and are no longer reimbursed through fee-for-service. The packet lists MH outpatient counseling and psychotherapy for independent and agency clinicians among the services for integration. Providers must enroll with the state before credentialing with the plans. [1][2] |
What New Jersey Medicaid (NJ FamilyCare)'s documents say
The table above has every field we found for New Jersey Medicaid (NJ FamilyCare), with numbered sources. In short:
- Prior authorization. The packet's Phase 1 table shows prior authorization required: No, for MH evaluation 90791-90792, individual psychotherapy 90832-90839, family therapy 90846-90847 and group therapy 90853. Check the plan for current rules.
- Who can bill. To bill independently, providers must enroll as an individual and be fully clinically licensed. For behavioral health this includes LCSWs, LPCs and LMFTs. Junior licensed providers (such as LSW or licensed associate MFT) and unlicensed providers cannot bill independently.
- Codes. 90791, 90832, 90834, 90837, 90846, 90847 and 90853 are listed.
Check New Jersey Medicaid (NJ FamilyCare)'s claim against the row
Before the claim goes out, compare it with the row above: the code matches the session length you documented, the place of service and modifier fit a video or audio-only visit, and the rendering clinician's license is one the payer enrolls. The psychotherapy table compares Medicaid with every other payer we checked.