N.J. Admin. Code § 10:52-5.9

Current through Register Vol. 56, No. 24, December 18, 2024

Section 10:52-5.9 - Reasonable cost of services related to patient care

(a) The reasonable cost of services related to patient care includes:

1. Current non-physician direct patient care costs per case as adjusted by standard costs per case for Medicaid/NJ FamilyCare fee-for-service inpatients;

2. Current physician patient service costs, as modified for physician compensation arrangements pursuant to N.J.A.C. 10:52-5.8;

3. Indirect cost pursuant to N.J.A.C 10:52-5.7 and 5.12;

4. Less a reduction for income not related to patient care, from those sources specified in N.J.A.C. 10:52-6.25 through 6.31 except all items reported as expense recovery to the Division, shall be so treated; and

5. Current major moveable equipment amount pursuant to N.J.A.C. 10:52-6.19 and 6.24.

(b) The reasonable cost of services related to Medicaid patient care will be adjusted by the application of economic factors pursuant to N.J.A.C. 10:52-5.13.

N.J. Admin. Code § 10:52-5.9

Amended by R.1995 d.141, effective 3/6/1995.
See: 27 N.J.R. 34(a), 27 N.J.R. 908(a).
Recodified from N.J.A.C. 10:52-5.13 and amended by R.2000 d.29, effective 1/18/2000.
See: 31 N.J.R. 3151(a), 32 N.J.R. 276(a).
In (a), inserted a reference to NJ KidCare fee-for-service inpatients in 1, and changed N.J.A.C. references in 2 through 4. Former N.J.A.C. 10:52-5.9, Current Cost Base, recodified to N.J.A.C. 10:52-5.5.
Amended by R.2005 d.214, effective 7/5/2005.
See: 37 N.J.R. 436(a), 37 N.J.R. 2506(a).
In (a), substituted "FamilyCare" for "KidCare" preceding "fee-for-service inpatients" in 1; in (b), amended the N.J.A.C. reference.
Amended by R.2011 d.010, effective 1/3/2011.
See: 42 N.J.R. 1656(a), 43 N.J.R. 43(a).
In (a)5, substituted "N.J.A.C. 10:52-6.19 and 6.24" for "N.J.A.C. 10:52-6.9".