Amerigroup. An Anthem Company.

New Jersey Providers

Welcome, providers!

Resources that help health care professionals do what they do best — care for our members.

At Amerigroup Community Care, we value you as a provider in our network. That is why we have redesigned the provider site to make it more useful for you and easier to use.

Interested in joining our provider network? We look forward to working with you to provide quality services to our members.

COVID-19 information

Amerigroup is closely monitoring COVID-19 developments and how the novel coronavirus will impact our customers and provider partners.

Availity access

The Availity Portal offers health care professionals free access to real-time information and instant responses in a consistent format regardless of the payer.

At Availity, you can:

Request authorizations.
Submit claims.
Confirm eligibility.

Receive email from Amerigroup

Amerigroup is now sending some bulletins, policy change notifications, prior authorization update information, educational opportunities and more to providers via email.

Provider News

The latest articles and announcements on claims filings, products, benefits, administrative updates, new and revised procedures and guidelines, prescription information, and more.

Medicaid updates

Quarterly pharmacy formulary change notice effective August 1, 2021

Formulary changes reviewed and approved at our 1st quarter 2021, pharmacy and therapeutics committee meeting.

Voluntary recall of Philips Respironics CPAP machine, BiPAP machine, and ventilators

On June 14, 2021, Philips Respironics* issued a voluntary recall on specific brands of their continuous positive airway pressure (CPAP) machines, bilevel positive airway pressure (BiPAP) machines, and ventilators.

Personal care group services authorization and claim coding

Effective July 1, 2021, providers requesting authorization or billing for personal care assistance group services must use code T1019-HQ. Any existing authorizations using code S5125 will be end-dated for June 30, 2021. Existing authorizations that extend beyond June 30, 2021, will be transitioned to code T1019-HQ and revised authorizations reflecting this change will be provided by fax.

Infusion Step Therapy Retraction Notice and Update about the EVV Mandate Removed

Providers are cordially invited to attend a live training webinar cohosted by CareBridge* and Amerigroup Community Care on June 4, 2021.

Aspire Health for NJ FamilyCare Members in Need of Palliative Care

Amerigroup Community Care works with Aspire Health to provide in-home and virtual palliative care services to our members facing advanced illness.

Medicare updates

Medicare Advantage — PN for UM AROW Item 1577

On September 1, 2021, Amerigroup prior authorization (PA) requirements will change for the following codes.

Medicare Advantage — PN for UM AROW Item 1330

On April 1, 2021, Amerigroup prior authorization (PA) requirements will change for the following codes.

Updates to AIM Clinical Appropriateness Guidelines for Radiation Oncology

New specialty pharmacy medical step therapy requirements

Effective January 1, 2021, the following Part B medications from the current Clinical Utilization Management (UM) Guidelines will be included in our medical step therapy precertification review process.

Featured resources

Pharmacy Information

Search for up-to-date drug information, including hundreds of brand-name and generic medications.

Maternal child program

When it comes to our pregnant members, we are committed to keeping both mom and baby healthy. We encourage all our moms-to-be to take part in our Taking Care of Baby and Me® program, which is a comprehensive, proactive case management and care coordination program for all expectant mothers and their newborns.

Behavioral health provider

We work collaboratively with hospitals, group practices and independent behavioral health care providers, community and government agencies, human service districts, and other resources to successfully meet the needs of members with behavioral health, substance use, and intellectual and developmental disabilities.

NCQA Health Plan Recognition

Amerigroup has been a NCQA Commendable plan in New Jersey since 2017.

Provider tools & resources

Interested in becoming a provider in our network?

We look forward to working with you to provide quality services to our members.