N.J. Admin. Code § 10:58-3.5

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

Section 10:58-3.5 - HCPCS Procedure Codes (Level III) and maximum fee allowance schedule for certified nurse midwifery services

HCPCS	Follow-up	Maximum Fee
IND	Codes	MOD	Days	Descriptions	Allowance
(a) Intrauterine Devices:
W0001	WM	30	Supplying and inserting the	$ 304.00
intrauterine device "Paragard" by a CNM
including the post-insertion visit.
W0002	WM	30	Supplying and inserting the	$ 137.00
intrauterine device "Progestasert" by a
CNM including the post-insertion visit.
W0004	WM	30	Removal of an IUD by a CNM followed at	$ 317.00
the same visit by the insertion of the
intrauterine device "Paragard" by a CNM
including the post-insertion visit.
W0008	WM	30	Removal of an IUD by a CNM followed at	$ 150.00
the same visit by the insertion of the
intrauterine device "Progestasert" by a
CNM including the post-insertion visit.
(b) HealthStart:
N	W9025	WM	HealthStart Initial Antepartum	67.00
Maternity Medical Care Visit by
Certified Nurse Midwife
N	W9026	WM	HealthStart Subsequent Antepartum	19.00
Maternity Medical Care Visit by
Certified Nurse Midwife
N	W9027	WM	HealthStart Regular Delivery by	371.00
Certified Nurse Midwife
N	W9028	WM	HealthStart Postpartum Care Visit by	19.00
Certified Nurse Midwife
N	W9029	WM	HealthStart Regular Delivery and	390.00
Postpartum Visit by Certified Nurse
Midwife
N	W9030	WM	HealthStart Total Obstetrical Care by	723.00
Certified Nurse Midwife
(c) Injections:
(d) EPSDT:
N	W9820	WM	Early and Periodic Screening, Diagnosis	18.00
and Treatment (EPSDT) from 2 through 20
years of age
(e) Maternity Care:
N	W9855	WM	Initial Visit Antepartum Visit by	15.40
Certified Nurse Midwife
N	W9856	WM	Subsequent Antepartum Visit by	11.20
Certified Nurse Midwife
(f) Delivery Services:
Z0250	WM	Home Delivery Pack (All drugs and	40.00
supplies, etc. necessary for delivery
in this setting.)
(g) Birth Centers Facility Fee:
W9858	Birth Center Services, global	1,300.00
W9859	Birth Center Services, limited	500.00

N.J. Admin. Code § 10:58-3.5

Amended by R.1998 d.209, effective 5/4/1998.
See: 30 N.J.R. 57(a), 30 N.J.R. 1613(a).
Rewrote the section.
Amended by R.2001 d.204, effective 6/18/2001.
See: 33 N.J.R. 1160(a), 33 N.J.R. 2188(a).
Rewrote (a) and (c).
Amended by R.2006 d.338, effective 9/18/2006.
See: 38 N.J.R. 2003(a), 38 N.J.R. 3900(a).
In (c), deleted table.