N.J. Admin. Code § 10:57-1.6

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

Section 10:57-1.6 - Basis of reimbursement

(a) Reimbursement for podiatry services covered under the New Jersey Medicaid/NJ FamilyCare fee-for-service program shall be on the basis of the customary charge, not to exceed a fixed fee schedule determined reasonable by the Commissioner, Department of Human Services (see N.J.A.C. 10:57-3for fee schedule), and further limited by Federal policy relative to payment of practitioners and other individual providers. In no event shall the payment exceed the charge by the provider for identical services to other governmental agencies, or other groups or individuals in the community.

(b) Any podiatric physician who meets the above cited qualifications listed in N.J.A.C. 10:57-1.3as a specialist and the requirements specified in N.J.A.C. 10:57-1.4shall be eligible for specialist reimbursement.

Amended by R.1998 d.382, effective 7/20/1998.
See: 30 N.J.R. 1255(b), 30 N.J.R. 2646(b).
In (a), inserted a reference to NJ KidCare; and in (b), inserted ", and prior to July 20, 1998," following "February 10, 1995", substituted "beneficiaries" for "recipients", inserted references to NJ KidCare throughout, and added the last sentence.
Amended by R.1999 d.292, effective 9/7/1999.
See: 31 N.J.R. 1304(a), 31 N.J.R. 2637(a).
In (a), inserted a reference to NJ KidCare programs.
Amended by R.2006 d.240, effective 7/3/2006.
See: 38 N.J.R. 1126(a), 38 N.J.R. 2805(a).
Substituted "FamilyCare" for "KidCare" throughout.

Amended by 53 N.J.R. 1001(b), effective 6/7/2021