N.J. Admin. Code § 10:58-2.12

Current through Register Vol. 57, No. 1, January 6, 2025

Section 10:58-2.12 - Clinical laboratory services; CNM referral to independent laboratory

(a) When the CNM refers a laboratory test to an independent clinical reference laboratory:

1. The clinical reference laboratory shall be certified under CLIA requirements to perform the required laboratory test(s) (see Section 1902(a)9 of the Social Security Act; 42 U.S.C. 1396 a(a)9; 42 C.F.R. 440.30, 493);

2. The clinical laboratory shall be licensed by the New Jersey State Department of Health in accordance with N.J.A.C. 8:44 and 8:45, or comparable agency in the state in which the laboratory is located; and

3. The clinical laboratory shall be approved for participation as an independent laboratory provider by the New Jersey Medicaid/NJ FamilyCare-Plan A fee-for-service programs.

(b) Independent clinical laboratories shall bill the New Jersey Medicaid/NJ FamilyCare-Plan A fee-for-service programs for all reference laboratory work performed on their premises. The CNM will not be reimbursed for laboratory work performed by a reference laboratory.

N.J. Admin. Code § 10:58-2.12

Amended by R.2001 d.204, effective 6/18/2001.
See: 33 N.J.R. 1160(a), 33 N.J.R. 2188(a).
In (a)3 and (b), inserted references to NJ FamilyCare-Plan A fee-for-service.

Amended by 53 N.J.R. 1843(c), effective 11/1/2021