N.J. Admin. Code § 10:60A-1.1

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

Section 10:60A-1.1 - Purpose and scope

(a) The purpose of this chapter is to provide standards for Medicaid/NJ FamilyCare reimbursement and Medicaid/NJ FamilyCare clinical eligibility for pediatric medical day care (PMDC) services.

1. PMDC is a program that provides medically necessary services in an ambulatory care setting to children who reside in the community and who, because they are technology-dependent and/or medically complex, require continuous rather than part-time or intermittent care of a registered professional nurse in a developmentally appropriate environment and whose needs cannot be met in a regular day care or pre-school handicapped program.

(b) This chapter applies to children who are Medicaid/NJ FamilyCare beneficiaries applying for authorization or reauthorization to participate in PMDC.

(c) This chapter applies to PMDC facilities that seek to participate in, and receive reimbursement for, providing PMDC services and to maintain their active Medicaid/NJ FamilyCare provider status.

N.J. Admin. Code § 10:60A-1.1

Amended and Recodified from 10:166-1.1 by 56 N.J.R. 262(a), effective 2/20/2024