N.J. Admin. Code § 10:52-2.5

Current through Register Vol. 56, No. 21, November 4, 2024

Section 10:52-2.5 - Family planning services

(a) Family planning services shall include medical history and physical examination (including pelvis and breast), diagnostic and laboratory tests, drugs and biologicals, medical supplies and devices, counseling, continuing medical supervision, continuity of care and genetic counseling.

(b) Services provided primarily for the diagnosis and treatment of infertility, including sterilization reversals, and related medical visits, drugs, laboratory, radiological and diagnostic services and surgical procedures shall not be covered services, except:

1. When a service is provided that is ordinarily considered an infertility service, but is provided for another purpose, then the hospital shall submit the claim with supporting documentation for medical review and approval of payment to the Division of Medical Assistance and Health Services, Office of Provider Relations, PO Box 712, Mail Code #27, Trenton, New Jersey 08625-0712.

N.J. Admin. Code § 10:52-2.5

New Rule, R.2000 d.29, effective 1/18/2000.
See: 31 N.J.R. 3151(a), 32 N.J.R. 276(a).
Former N.J.A.C. 10:52-2.5, Home health agencies; hospital-based, recodified to N.J.A.C. 10:52-2.6.
Amended by R.2005 d.214, effective 7/5/2005.
See: 37 N.J.R. 436(a), 37 N.J.R. 2506(a).
In (b), substituted "FamilyCare" for "KidCare-Plan A, B and C" in the introductory paragraph; in (f), deleted "Medical Affairs and" preceding "Provider Relations" and substituted "27" for "14" following "Mail Code #" in 1.
Amended by R.2011 d.010, effective 1/3/2011.
See: 42 N.J.R. 1656(a), 43 N.J.R. 43(a).
Deleted (b) through (e); and recodified (f) as (b).