The New Jersey Department of Human Services, Division of Medical Assistance and Health Services (DMAHS) has increased the minimum hourly rate requirements that Aetna Better Health of New Jersey and other Medicaid Managed Care Organizations must pay for Personal Care Assistance (PCA) services.
Effective July 1, 2020, the new, mandated rate for PCA services to individuals is $21 per hour for services provided from July 2020 to August 2020 and $19 per hour for services provided from September 2020 to June 2021.
As always, providers must bill Aetna Better Health of New Jersey for such PCA services in 15-minute units using code T1019.
Aetna Better Health of New Jersey will update our payment system to include the new rate effective July 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 July 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.
