New Jersey Medical Lien Law for Outpatient Providers (2026)

New Jersey's lien statute covers hospitals, nursing homes, and licensed physicians and dentists, so orthopedic, pain and neurology practices can hold a statutory lien. The physician lien must be filed with the county clerk within 90 days of first treatment, served within 10 days after filing, and is capped at 25% of the recovery. In car-accident cases, personal injury protection (PIP) pays first at fee-schedule rates.

At a glance

Question	Answer
Statutory lien for outpatient providers	Yes, for licensed physicians and dentists (plus hospitals and nursing homes). Chiropractors, physical therapists and other practitioners are not named.
Main law	N.J.S.A. 2A:44-35 to 2A:44-46
What outpatient providers usually rely on	Physicians can use the statute. Auto cases are paid mainly through PIP. Other providers rely on lien agreements and letters of protection.
Notice or filing	File with the county clerk where the injury happened, before any payment and within 90 days after first treatment. Serve a copy within 10 days by registered mail or personal delivery, or the lien is void.
Limits on the amount	Physician and dentist lien: reasonable value, no more than 25% of the award or settlement. Hospitals: ward rates. Nursing homes: minimum per diem rate. Auto PIP: fee schedule.
Health insurance and billing the patient	Auto: PIP pays first, or the patient's health insurance if the patient chose it as primary. Providers may not demand payment above the PIP fee schedule.
Billed vs. paid in the case	Collateral-source benefits that duplicate the award are deducted (N.J.S.A. 2A:15-97), except in auto no-fault actions. In auto cases, amounts collectible under PIP are inadmissible (N.J.S.A. 39:6A-12).
Recent changes (2023–2026)	ACPE Opinion 748 (2024) on when lawyers must honor liens, including letters of protection. Murray v. Punina (N.J. 2026) on future medical expenses within PIP limits.

Is there a lien law for outpatient providers?

Yes, for physicians and dentists. N.J.S.A. 2A:44-36 gives a lien to "every hospital and nursing home in this State, and every licensed physician or dentist practicing in this State" for treating a person injured in an accident caused by someone else's negligence or alleged negligence.

The lien attaches to the patient's claim against the liable party and to any judgment, award or settlement, up to the date damages are paid (N.J.S.A. 2A:44-37). "Services" includes pharmaceuticals, supplies, examinations, tests and therapies (N.J.S.A. 2A:44-35). The statute does not define "physician."

Chiropractors, physical therapists, imaging centers and ambulatory surgery centers are not named in the statute. There is no lien under this law for injuries from an accident covered by workers' compensation (N.J.S.A. 2A:44-40).

How a lien is perfected

Filing: a written notice must be filed with the county clerk in the county where the injury happened, before any money is paid to the patient, "and in no event later than 90 days after the date of such first treatment." The notice lists the patient's name and address, the date and place of the accident, the date of first treatment, the provider's name and address, and, if reasonably available, the names and addresses of those alleged to be liable. The clerk keeps a separate physician and dentist lien docket (N.J.S.A. 2A:44-41).
Service: within 10 days after filing, the provider sends a copy, with the filing date, by registered mail or personal delivery to the patient and the alleged liable party. If the provider fails to do this when the names and addresses are known or should be known, the lien is void (N.J.S.A. 2A:44-42).
Enforcement: after filing and service, a release signed by the patient does not defeat the lien. Anyone who pays the patient stays liable to the provider for one year from the payment, and the provider may sue within that year (N.J.S.A. 2A:44-43).
Records on request: on written request from a liable party, a physician or dentist must provide a statement of injuries and an itemized bill. Failing to do so is a valid defense to enforcing the lien (N.J.S.A. 2A:44-44). Hospitals and nursing homes have a similar duty (N.J.S.A. 2A:44-45).
Discharge: once paid or released, the provider files an acknowledged certificate with the county clerk to discharge the lien (N.J.S.A. 2A:44-46).

Limits on what the provider is paid

Physicians and dentists: the lien is "based on the reasonable value" of services, "but not to exceed twenty-five per centum (25%)" of any award, judgment or settlement (N.J.S.A. 2A:44-39).
Hospitals: no more than ward rates up to the date of payment (N.J.S.A. 2A:44-38).
Nursing homes: the minimum per diem rate for ordinary patient care (N.J.S.A. 2A:44-39.1).
Auto PIP: providers are limited to the regional PIP medical fee schedules (N.J.S.A. 39:6A-4.6).

Lien agreements and letters of protection

Providers the statute does not name rely on written lien agreements and letters of protection. New Jersey's Advisory Committee on Professional Ethics treats a lawyer's promise to a medical provider "reflected in a letter of protection" as a lien the lawyer must honor (ACPE Opinion 748).

The attorney's duty to pay the provider

ACPE Opinion 748 (September 17, 2024), applying RPC 1.15, says the patient's attorney must honor:

valid, undisputed statutory liens, such as Medicare, Medicaid, ERISA, workers' compensation and child support liens;
liens the attorney agreed to pay, such as a promise to a medical provider in a letter of protection; and
liens the client agreed to pay from the proceeds and told the attorney about.

For other liens, the attorney may release funds to the client after telling the client about the lien and possible liability. The opinion also says some provider bills are not amounts the provider is entitled to receive, such as balance billing, billing health insurance instead of PIP, or charges for unrelated services. Without an express agreement, the attorney has no ethical duty to pay those.

Separately, a statutory lien that has been filed and served binds whoever pays the patient for one year (N.J.S.A. 2A:44-43).

Health insurance, no-fault and billing the patient

Auto cases: PIP medical coverage is $250,000 if the insured makes no written choice. Lower options are $150,000, $75,000, $50,000 or $15,000. The insured may choose health insurance as primary, with PIP paying what the health plan does not. Providers and insurers may not seek subrogation for deductibles or copayments (N.J.S.A. 39:6A-4.3).
No balance billing above the fee schedule: "No health care provider may demand or request any payment from any person in excess of those permitted by the medical fee schedules," and no one is liable for that excess (N.J.S.A. 39:6A-4.6(c)).
Non-auto cases: we could not confirm in a primary source whether a provider must bill the patient's health insurance before relying on a lien.

Billed vs. paid medical damages

New Jersey has no "paid or incurred" statute. Under the collateral source statute, N.J.S.A. 2A:15-97, benefits from sources other than a joint tortfeasor that duplicate the award are deducted, less premiums the plaintiff or family paid for the benefit period. Workers' compensation and life insurance are not deducted. The statute does not apply to actions under the auto no-fault law.

In auto cases, evidence of amounts collectible or paid under PIP, including deductibles, copays and exclusions, is inadmissible in the lawsuit (N.J.S.A. 39:6A-12). As amended in 2019 (L.2019, c.244), the section preserves recovery of uncompensated economic loss and states that medical expenses above, or unpaid or uncovered by, the PIP limits can be claimed against liable parties regardless of health insurance.

Before that amendment, the Supreme Court in Haines v. Taft, 237 N.J. 271 (2019) had held that plaintiffs could not present medical expenses above their elected, lower PIP limits. The amended text now expressly allows that recovery.

Recent changes

ACPE Opinion 748 (September 17, 2024): sets out when lawyers must honor liens, including promises made in letters of protection.
Murray v. Punina, 264 N.J. 1 (2026), decided May 6, 2026: the Supreme Court held that future medical expenses within PIP limits are "collectible" and inadmissible under N.J.S.A. 39:6A-12, and removed the future-medical award and related offer-of-judgment fees.
The 2025 text of N.J.S.A. 2A:44-36, -39 and -42 shows no amendments after 1970.

What this means for your practice

Licensed physicians, such as orthopedic, pain management and neurology practices, have a statutory lien in New Jersey, but only if it is filed with the county clerk within 90 days of first treatment and served within 10 days after filing. A lien not served when the parties' addresses are known is void.
The physician lien is capped at 25% of the recovery, so a large bill on a small settlement may not be paid in full through the lien.
Chiropractors, physical therapists, imaging centers and surgery centers are not named in the statute. They depend on lien agreements and letters of protection, which ACPE Opinion 748 says the patient's attorney must honor when the attorney agreed to pay.
In auto cases, PIP (or the patient's health plan, if chosen as primary) pays first at fee-schedule rates. Providers cannot bill the patient above the fee schedule, and the attorney has no ethical duty to pay bills that should have gone to PIP.
Future medical expenses within PIP limits are inadmissible in auto cases after Murray v. Punina (2026), which can lower the medical-damages value of a case.

Sources

How we verified: the key lien sections (N.J.S.A. 2A:44-36, 2A:44-39 and 2A:44-42) were checked against the 2025 New Jersey Revised Statutes on Justia, and the Murray v. Punina opinion against the official copy on njcourts.gov, on November 12, 2026.