New Jersey Medicaid: New palliative care assistance program

As of April 1, 2026, UnitedHealthcare Community Plan of New Jersey has a new Community-Based Palliative Care (CBPC) program for New Jersey FamilyCare members. CBPC can help improve quality of life and reduce avoidable acute care utilization for members living with serious illness. Unlike hospice, CBPC doesn’t require a terminal prognosis or stopping curative treatment. Services are designed to work alongside active care.

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As part of the new program launch, any health care professional in our network may perform both initial assessments and reassessments. To offer the PMPM bundle, enrollment in the CBPC network is required. This requirement helps prevent claim denials for CBPC services and ensures members receive full access to the benefit.

Claim codes for CBPC services

If your claim is denied because you’re not registered in the CBPC, you’ll see one of the following denial codes on your remittance advice:

Service	Code	FFS rate floor	Required activities
Initial assessment	S0280	$100	Submission of comprehensive medical assessment tool to managed care organization (MCO) Prior authorization not required
PMPM bundle	S0311	$696	Documentation of care coordination activities and EHR recordkeeping, record retention in case of MCO audit Prior authorization is required
Reassessment	S0281	$85	Submission to MCO and end of 6 month authorization window or upon significant change in member condition Prior authorization is not required

Questions? We’re here to help.

Connect with us through chat 24/7 in the UnitedHealthcare Provider Portal. You can also contact UnitedHealthcare Provider Services at 888-362-3368, 8 a.m.–5 p.m. ET, Monday–Friday.

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