On June 30, 2025, the New Jersey Department of Human Services announced plans to seek CMS approval for a Medicaid State Plan amendment that would raise primary care reimbursement rates, including pediatrics. The proposal allocates about $11.2M in new funding for FY 2026, with similar levels anticipated in FY 2027. If approved, pediatricians could see higher payments for evaluation and management (E/M) and vaccine administration services, supporting longer visits, well-child checks, and coordination of care.
Frier Levitt partner Guillermo Beades discusses this in his article, “New Jersey’s Department of Human Services Seeks Approval for Increased Rates for Adult and Pediatric Primary Care” published in NJAAP. In the piece, he explores the impact this will have on pediatrics, the unintended consequences, and how practices can be proactive and remain compliant.
