Subject:  Notice to Home Health, Personal Care Assistant and Nursing Facility Providers
Date:  October 19, 2020
The New Jersey Fiscal Year 2021 budget has increased several rates that that Aetna Better Health of New Jersey and other Medicaid Managed Care Organizations must pay for the following services:
SERVICE


Medical Day Care (Adult Day Health Services)    


Nursing Facilities Rates


Personal Care Assistant (PCA) Services


Private Duty Nursing Services - RN

Private Duty Nursing Services - LPN
STATE MANDATED REIMBURSEMENT RATE

$82.00 per day



Specific rate set by NJ Medicaid for each facility

$21 per hour
$19 per hour
$20 per hour

$60 per hour


$48 per hour 
EFFECTIVE DATE


10/1/2020



10/1/2020


7/1/2020 to 8/31/2020
9/1/2020 to 9/30/2020
10/1/2020 to 6/30/2021

10/1/2020


10/1/2020
Aetna Better Health of New Jersey will update our payment system to include the new rate effective October 1, 2020. To account for the new rate, Aetna Better Health of New Jersey will retroactively adjust any impacted claim payments for dates of service on or after October 1, 2020. You will not need to resubmit claims, as Aetna Better Health of New Jersey will reprocess based on claims already submitted.

If you have any questions regarding Aetna Better Health of New Jersey implementation of this rate change, please contact Mary Pagano, Network Relations Manager at PaganoM@aetna.com.