N.J. Admin. Code § 10:60-1.1

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

Section 10:60-1.1 - Purpose and scope

(a) The purpose of this chapter is to explain the rules under which home care services are administered to those individuals determined eligible to receive such services on a fee-for-service basis.

(b) This chapter provides requirements for, and information about, the following services and programs:

1. Home health services;

2. Personal care assistant services;

3. Early and Periodic Screening, Diagnosis and Treatment/Private Duty Nursing (EPSDT/PDN) Services;

4. Home and Community-Based Services Waiver programs, which are administered by the Department of Human Services through 42 U.S.C. § 1915(c) waivers, as follows:

i. Home and Community-Based Services Waiver for Intellectually and/or Developmentally Disabled (DDD-CCW) Individuals; and

5. The New Jersey Comprehensive Waiver demonstration programs (Section 1115): NJ FamilyCare managed long-term services and supports (MLTSS).

(c) Home health agencies and health care service firm agencies are eligible to participate as Medicaid/NJ FamilyCare fee-for-service home care services providers. The services that each type of agency may provide and the qualifications required to participate as a Medicaid/NJ FamilyCare provider are listed at N.J.A.C. 10:60-1.2 and 1.3.

(d) General information about the home health agency services program and the personal care assistant services program are outlined in this subchapter. Specific program requirements are provided in N.J.A.C. 10:60-2 and 3, respectively.

(e) N.J.A.C. 10:60-11, CMS Common Procedure Coding System-HCPCS, outlines the procedure codes used to submit a claim for services provided in accordance with this chapter.

N.J. Admin. Code § 10:60-1.1

Amended by 50 N.J.R. 1992(b), effective 9/17/2018

Amended by 54 N.J.R. 1721(a), effective 9/6/2022