Surprise bills and ambulance bills in New Jersey
For emergency or urgent care at any hospital or other facility, and for out-of-network care you did not choose at an in-network facility (inadvertent out-of-network care), the facility and professionals may bill you only your in-network deductible, copay or coinsurance.
Checked against official sources: October 30, 2026.
What New Jersey adds
- State law
Out-of-network Consumer Protection, Transparency, Cost Containment and Accountability Act
Law: P.L.2018, c.32; N.J.S.A. 26:2SS-4, 26:2SS-5, 26:2SS-7, 26:2SS-8, 26:2SS-11
- Which plans it covers
State-regulated health plans. Self-funded employer plans are covered only if the plan chooses to opt in; members of other self-funded plans can use state arbitration for a disputed bill.
- What it adds
For emergency or urgent care at any hospital or other facility, and for out-of-network care you did not choose at an in-network facility (inadvertent out-of-network care), the facility and professionals may bill you only your in-network deductible, copay or coinsurance. Before a non-emergency procedure, facilities and professionals must tell you whether they are in network.
Law: N.J.S.A. 26:2SS-4, 26:2SS-5, 26:2SS-7, 26:2SS-8, 26:2SS-11
Itemized bills and price estimates in New Jersey
New Jersey law gives you a right to an itemized bill.
As a hospital patient, you have the right to examine and get an explanation of your bill, whatever the source of payment. The Department of Health says you have the right to receive a copy of the hospital charges, an itemized bill if you ask, and an explanation, and to appeal charges and get an explanation of the appeals process.
Law: N.J.S.A. 26:2H-12.8(m)
Price estimates
If a health care professional is out of your plan's network, before scheduling a non-emergency procedure the professional must tell you so and that an estimate is available. If you ask and give the service and its CPT codes, the professional must tell you in writing the amount or estimated amount they will bill you. Facilities must post their standard charges and the plans they participate in.
Law: N.J.S.A. 26:2SS-4, 26:2SS-5
Where to complain in New Jersey
- Hospital bills and financial assistance: New Jersey Department of Health, Charity Care Unit · 1-866-588-5696
Questions or concerns about charity care, how a hospital applied the rules, or your application. - Attorney general: New Jersey Division of Consumer Affairs (Office of the Attorney General)
A provider or debt collector broke the Medical Debt Relief Act (credit reporting, waiting periods, interest, garnishment) or other consumer laws. - Health insurance: New Jersey Department of Banking and Insurance, Consumer Inquiry and Response Center · 1-800-446-7467
Problems with a state-regulated health plan, including surprise out-of-network bills.