NJ – DHS Expands Behavioral Health Benefits Covered Under NJ FamilyCare

November 2017 ~

The New Jersey Department of Human Services (DHS) last month announced that it has expanded the list of covered health benefits available to align behavioral health coverage for Medicaid Long Term Services and Supports (MLTSS), Fully Integrated Dual Eligible Special Needs Plans (FIDE SNPs), and Division of Developmentally Disabled (DDD) MCO members participating in the New Jersey FamilyCare (NJFC) Medicaid managed care program.

The expanded NJFC health plan benefit coverage will include (with some exceptions regardless of age) the following:

  • All mental health benefits
  • Substance used disorder (SUD) services
  • General acute care hospital and psychiatric unit admissions
  • Air emergency ambulance transports
  • Ambulatory Drug Withdrawal Management (AWM) services

Several behavioral health services will remain in fee-for-service (FFS), including targeted case management (TCM), integrated case management services (ICMS), behavioral health homes (BHH), and community support services (CSS). These changes will become effective January 1, 2018.


Source(s): CMS; State of New Jersey Division of Medical Assistance and Health Services;