N.J. Admin. Code § 10:58-2.5

Current through Register Vol. 56, No. 23, December 2, 2024

Section 10:58-2.5 - Evaluation and management: consultations requested by CNMs

(a) A consultation shall be reimbursed by the New Jersey Medicaid/NJ FamilyCare fee-for-service programs when performed by a physician specialist (other than her collaborating physician) recognized as such by the Medicaid/NJ FamilyCare programs and when the request is made by or through the patient's CNM. The need for such a request shall be consistent with good medical practice.

(b) When the CNM needs to refer the patient(s) for consultation or for other services, the provider of the consultation or other service shall bill the New Jersey Medicaid/NJ FamilyCare-Plan A fee-for-service programs directly and shall be reimbursed directly for the consultation or referred service.

N.J. Admin. Code § 10:58-2.5

Amended by R.2001 d.204, effective 6/18/2001.
See: 33 N.J.R. 1160(a), 33 N.J.R. 2188(a).
Inserted "NJ FamilyCare fee-for-service" following "Medicaid" throughout section.