N.J. Admin. Code § 10:58-1.8

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

Section 10:58-1.8 - Personal contribution to care requirements for NJ FamilyCare Children's Program-Plan C and copayments for NJ FamilyCare-Plan D

(a) General policies regarding the collection of personal contribution to care for NJ FamilyCare Children's Program-Plan C and copayments for NJ FamilyCare-Plan D services are set forth at N.J.A.C. 10:49-9.

(b) The personal contribution to care for NJ FamilyCare-Children's Program-Plan C services is $ 5.00 a visit for office visits, except when the service is provided for prenatal care, preventive care or for family planning services.

1. An office visit is defined as a face-to-face contact with a medical professional which meets the requirements of this chapter and which allows the certified nurse midwife to request reimbursement.

2. Office visits include certified nurse midwife services provided in the office, patient's home, birth center, or any other site, except hospital.

(c) Certified nurse midwives shall not charge a personal contribution to cost of care for services provided to newborns, who are covered under fee-for-service for Plan C; for family planning services, or for prenatal care.

(d) The copayment for nurse midwifery services under NJ FamilyCare-Plan D shall be $ 5.00 per office visit;

1. A $ 10.00 copayment shall apply for services rendered during non-office hours and for home visits.

2. The $ 5.00 copayment shall apply only to the first prenatal visit.

(e) Certified nurse midwives shall collect the copayment specified in (d) above except as provided in (f) below. Copayments shall not be waived.

(f) Certified nurse midwives shall not charge a copayment for services provided to newborns, who are covered under fee-for-service for Plan D.

N.J. Admin. Code § 10:58-1.8

New Rule, R.1998 d.154, effective 2/27/1998 (operative March 1, 1998; to expire August 31, 1998).
See: 30 N.J.R. 1060(a).
Former N.J.A.C. 10:58-1.8, Recordkeeping; general, recodified to N.J.A.C. 10:58-1.9.
Adopted concurrent proposal, R.1998 d.487, effective 8/28/1998.
See: 30 N.J.R. 1060(a), 30 N.J.R. 3519(a).
Readopted the provisions of R.1998 d.154 without change.
Amended by R.1999 d.211, effective 7/6/1999 (operative August 1, 1999).
See: 31 N.J.R. 998(a), 31 N.J.R. 1806(a), 31 N.J.R. 2879(b).
In (a), added reference to copayments for NJ KidCare-Plan D; added (d) through (f).
Amended by R.2006 d.338, effective 9/18/2006.
See: 38 N.J.R. 2003(a), 38 N.J.R. 3900(a).
Section was "Personal contribution to care requirements for NJ KidCare--Plan C and copayments for NJ KidCare--Plan D". In (a), substituted "FamilyCare Children's Program" for the first occurrence of "KidCare" and "FamilyCare" for the second occurrence; in the introductory paragraph of (b), substituted "The personal" for "Personal" and "FamilyCare-Children's Program" for "KidCare"; and in (d), substituted "FamilyCare" for "KidCare".