Please submit email inquiries about the transition to Fee for Service to: FFS.Transition@dhs.state.nj.us
March 2019
March 5, 2019 Letter from Commissioner Johnson letter about revised Outpatient Rates
December 2019
NJMHAPP Provider Program Manual 4.6.0
Mental Health Fee for Service Transition Section
July 2017
July 24, 2017 Letter from Acting Commissioner Connolly about FY17 contract surpluses
June 2017
Fee for Service Presentation before GPPH Board Meeting- June 15, 2017
May 2017
Mental Health Fee for Service Cash Advance Letter
April 2017
Communication from Assistant Commissioner Mielke (FFS/Rates)
FFS Phase 2 Transition Information Session April 2017
NJ Mental Health Payment Processing Application (NJMHAPP) Phase 2 Presentation April 2017
CSS Information Session April 2017 Presentation
NJMHAPP Phase 2 CSS Presentation April 2017
February 2017
Updated Mental Health FFS FAQs February 2017
January 2017
DMHAS NJMHAPP Presentation
Phase 2 FFS Provider Information Sessions
December 2016
FFS Transition Information Sessions
October 2016
CY 2017 DMHAS Contract Review & Award Process
Mental Health Fee for Service Newsletter Volume 1, Edition 1 - August 12, 2016
Mental Health Fee for Service Newsletter Volume 1, Edition 2 - Nov. 23, 2016
June 2016
The Frequently Asked Questions (FAQs) document addresses general transition, contracting, rates and Medicaid questions and substance use disorder and mental health program specific questions:
FFS Frequently Asked Questions Updated (June 24, 2016)
Letter from DMHAS’s CFO about the revised deadline of August 15, 2016 for Providers to advise DMHAS of their transition date:
MHS FFS Conversion Revised Date Notice
This letter dated June 28, 2016 from Acting Commissioner Connolly provides an update on the NJ DMHAS's rates:
Rates Update from Acting Commissioner Connolly June 28,2016
May 2016
Correspondence about the option of Mental Health Providers to transition to Fee for Service either January 2017 or July 2017:
FFS Amended Update from Assistant Commissioner Mielke, May 13, 2016
Provider Letter Transition January or July 2017 Options
Memoranda from DMHAS Chief of Contracts Bureau about Outpatient Ceiling Reductions for FY17:
FY17 Ceiling Reductions due to Increased Medicaid Outpatient Rates
PowerPoint of the Community Support Services (CSS) Rates:
CSS Rates PowerPoint May 24, 2016
This PowerPoint was presented in 3 regional stakeholder listening sessions. The intention of the listening sessions was to solicit stakeholder feedback about DMHAS’s transition to Fee for Service, to inform ongoing planning efforts:
May/June FFS Transition Listening Session PPT
April 2016
This letter provides updates on FFS activities and includes information about rates changes to PACT and SUD Intensive Outpatient, methadone treatment in an Opioid Treatment Program and Buprenorphine Treatment in an Opioid Treatment Program:
FFS update from Assistant Commissioner Mielke, April 18, 2016
This correspondence outlines the timeline for Community Support Services and the delay of deficit funded contracts transition until July 1, 2017:
CSS update from Assistant Commissioner Mielke, April 26, 2016
February/March 2016
This PowerPoint outlines NJ DMHAS’s rate setting process, rates assumptions and rates for Substance Use Disorder Services and Mental Health Service. The presentation of the rates was done in a series of meetings in February and March:
Rate Setting Transition Overview (June 29, 2016)
Rates Only Slides
A link to a YouTube video of Assistant Commissioner Valerie Mielke’s presentation of the new rates for behavioral health services:
Mental Health Fee for Service Video Presentation
Substance Abuse Fee for Service Video Presentation
Addiction Services Fee for Service
Click here for the IME Training Information Page:
State Targeted Opioid Response Initiative(STORI) Fee for Service Presentation
IME Phase I
Information Regarding Phase I of the IME Roll Out. This includes information regarding the IME call center line, the IME screening and referral, and IME Care Coordination. Information on IME Affiliation Agreements, the IME Service Capacity Management System (SCMS) and obtaining authorization for State funded assessments is also included. June/July 2015
General Overview of Phase I of the IME:
IME Overview
Individual descriptions of the IME functions and how they relate to provider operations:
IME Fact Sheets
FAQ’s from Phase I Implementation:
IME Frequently Asked Questions (July 30, 2015)
Flow chart of the IME Functions in NJSAMS for Phase I and preview of the Phase II implementation:
Basic IME Flow Chart
Overview of the changes in NJSAMS for Phase I of the IME:
NJSAMS 3.0 Overview
Description and information on the Service Capacity Management System used by the IME to make referrals to providers:
Service Capacity Management System (SCMS) - Provider Tip Sheet (June 2015)
Fee For Service Network Revisions for SFY17-18
Information regarding the codes and the rate changes for SUD FFS Initatives implemented in July 2016.
Fee for Service Revisions (SFY 17-18)
Q & A about the new rates:
Rates Questions and Answers
The roll out of the rates to small groups of providers:
Rate Setting Transition Overview
Rates updated from the initial list after provider feedback:
Rates Update from Acting Commissioner Connolly (June 28, 2016)
Medicaid Rates Newsletter (July 2016)
Payer of last resort:
Provides guidance on choosing payer source for clients in accordance with state and federal funding regulations:
NJ Family Care/Medicaid Reimbursement for Services Rendered (Payor of Last Resort 22, 2015)
This correspondence from NJ DMHAS’s Assistant Commissioner details the requirement that providers become Medicaid enrolled providers and the process by which to enroll:
Requirements to Become a Medicaid Provider (March 21, 2014)
Administrative Authorizations for Medicaid and State Services:
These power points provide information for obtaining authorizations for client’s receiving services before the IME began prior authorization process.
This PowerPoint is from a webinar for providers, describes how to obtain Administrative Prior Authorizations for State Contract Conversion Slots:
Obtaining State Administrative Prior Authorizations for Contract Conversion (June 2016)
This PowerPoint provides information about the Administrative Prior Authorization Process for consumers admitted to services or obtain Medicaid coverage between January 19 and May 23, 2016:
IME Prior Authorization Training (November 2015)
These screenshots and directions from NJSAMS guide you through the processing of submitting a client to the IME that was served in a slot previous to July 1, 2016 for which provider did not receive an Administrative Authorization:
How to submit clients to IME for review and authorization July 6, 2016
Contract Conversions:
Information regarding the new initiatives developed from the contract conversion:
FFS Revisions
FFS General Information
This link leads to the FFS documents posted on NJSAMS:
https://njsams.rutgers.edu/njsams/Documents.aspx
Initiative Specific ASAM Ambulatory, ASAM Residential and Enhancement excel sheets and, SFY 2017 Extension Request LOC parameters, click on triangle to the left of the link:
Contract > FFS Documents > Benefit/ Business Rule Package for SFY 2017
For current FFS approved providers by FFS Initiative sorted by County, click on triangle to the left of the link:
Contract > FFS Documents > FFS Approved Provider lists
Phase II of the IME/Utilization Management
Phase II of the IME included the start of full utilization management. The Phase II includes full clinical review of the requests for authorization for new clients served through state initiatives and Medicaid.
Provides clinical guidance for providers on completing a LOCI and communicating clinical/medical necessity to the IME Utilization Management staff:
Tips to Get Your Clinical/Medical Necessity Authorization Presentation (Feb 2016)
This PowerPoint provides information about the IME Phase II implementation, including full utilization management of managed initiatives, significant changes in NJSAMS, changes in claims and conversion of slot based contracts to Fee for Service:
IME Phase II Training (May 2016)
Cash Advance Policy and Related Documents for Substance Use Disorder Providers (June 21, 2016)
Cash Advance Agreement
Cash Advance Attestation Form
Frequently Asked Questions for Phase II of the IME, including information about the Prior Authorization Process,. These questions were collated from the Phase II trainings conducted in May and June of 2016. (June 28, 2016):
IME Phase II FAQs (June 28,2016)
This IME Discussion Group PowerPoint includes information and statistics about IME implementation, outline of issues encountered by providers and proposed solutions:
IME Discussion Groups PowerPoint (June 2016)
This document is a summary of two conference calls lead by the DMHAS and NJFamilyCare to address questions and concerns about the authorization processes after the contract conversion.
IME Provider Questions (updated July 11, 2016)
