N.J. Admin. Code § 10:56-2.8

Current through Register Vol. 56, No. 12, June 17, 2024

Section 10:56-2.8 - Diagnostic services: Clinical laboratory services

(a) "Clinical laboratory services" includes services provided by:

1. Independent clinical laboratories, including physician/dentist operated, out of hospital laboratories which perform primarily diagnostic work referred by other practitioners; and

2. Hospital laboratories and laboratories of educational institutions which provide laboratory services to ambulatory beneficiaries as requested by a licensed practitioner.

(b) Services provided by any of the above laboratories shall be billed directly to the Medicaid/NJ FamilyCare program by the laboratory, and not by the dentist.

(c) All facilities or entities that perform clinical laboratory testing shall have certification for the services they are performing (see N.J.A.C 10:61). Reimbursement for laboratory testing performed shall not be made to any facility without such CLIA certification. It shall be the initiating entity's responsibility to refer tests to laboratories which are New Jersey Medicaid/NJ Family Care fee-for-service providers and have a valid CLIA identification number.

N.J. Admin. Code § 10:56-2.8

As amended, R.1982 d.403, effective 11/15/1982. (Operative date: February 1, 1983.)
See: 13 N.J.R. 875(a), 14 N.J.R. 1301(a).
Section substantially amended.
As amended, R.1983 d.584, eff. 1/1/1984.
See: 15 N.J.R. 1160(a), 15 N.J.R. 2170(a).
Amended by R.1986 d.385, effective 9/22/1986.
See: 18 N.J.R. 1337(a), 18 N.J.R. 1958(a).
Section renumbered and (b)4 new.
Recodified from 10:56-1.14 and amended by R.1996 d.428, effective 9/16/1996.
See: 28 N.J.R. 3069(a), 28 N.J.R. 4243(a).
Amended by R.2001 d.268, effective 8/6/2001.
See: 33 N.J.R. 1554(a), 33 N.J.R. 2666(b).
In (a)2, substituted "beneficiaries" for "recipients"; in (c), inserted "/NJ Family Care fee-for-service" preceding "providers".
Amended by R.2004 d.25, effective 1/20/2004.
See: 35 N.J.R. 4032(a), 36 N.J.R. 568(a).
In (b), inserted reference to NJ FamilyCare.
Amended by R.2007 d.36, effective 2/5/2007.
See: 38 N.J.R. 3419(a), 39 N.J.R. 479(a).
In (b), substituted "shall" for "must".