N.J. Admin. Code § 10:54-5.14

Current through Register Vol. 56, No. 11, June 3, 2024

Section 10:54-5.14 - EPSDT and pediatric HealthStart

(a) EPSDT providers may apply to the New Jersey Department of Health and Senior Services for certification as Pediatric HealthStart providers.

(b) HealthStart is a program of enhanced maternity care and preventive health care for children under 2 years of age. Certified Pediatric HealthStart providers agree to assure continuity of care by following up on referrals and missed appointments, making available 24 hour telephone access and sick care, either directly or by formal arrangement with another pediatric provider.

(c) Pediatric HealthStart providers are approved for a higher reimbursement for preventive child health examinations (screening) than other EPSDT providers, in accordance with the requirements of N.J.A.C. 10:54-6.

(d) EPSDT/HealthStart screening services are billed on the Report and Claim for EPSDT/HealthStart Screening and Related Procedure Form using HealthStart specific procedure codes as listed in 10:54-9.4, 10:54-9.10(l), and 10:54-9.10(k).

(e) EPSDT/HealthStart claims shall be submitted within 30 days of the date of service.

N.J. Admin. Code § 10:54-5.14

Amended by R.2001 d.51, effective 2/5/2001.
See: 32 New Jersey Register 3929(a), 33 New Jersey Register 555(a).