Effective January 1, 2022, ABHNJ and Aetna Assure Premier Plus (HMO D-SNP) will be increasing the reimbursement rates for PCA providers as follows:
The attached Medicaid Newsletter specifies that PCA provider agencies submitting claims for individual PCA services (T1019) at the increased rate acknowledge through such claim submission that it will use the entire additional amount ($1.00) to increase the wage of the PCA worker who performed the billed services. PCA providers billing the increased rate further acknowledge that they must retain adequate evidence of this payment and that the entire rate increase may be subject to remediation and/or penalty if it is used for any other purpose. DMAHS will be providing additional information regarding reporting requirements for providers in the near future.
For more information, you may direct questions to mahs.provider-inquiries@dhs.nj.gov. You can also call Provider Services at 1-855-232-3596 (TTY: 711).
