N.J. Admin. Code § 10:66-2.6

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

Section 10:66-2.6 - Laboratory services

(a) As required by the Clinical Laboratory Improvement Amendments of 1988 (CLIA), referenced at 42 CFR 493, all facilities or entities that perform clinical laboratory testing shall have their CLIA identification number on file with the New Jersey Medicaid and NJ FamilyCare fee-for-service programs.

(b) A clinic shall only claim reimbursement for those laboratory services that have been performed by them on their premises, for their patients, and for which they have received approval by the New Jersey Medicaid and NJ FamilyCare fee-for-service programs, as indicated in 10:66-1.3(a).

(c) Laboratory procedures are reimbursable only when performed in accordance with the applicable CLIA-mandated certificate of registration, certificate of waiver, or certificate of physician-performed microscopy procedures.

(d) Specific laboratory procedures are reimbursable when performed in conjunction with an EPSDT screening, if the requirements of (a), (b) and (c) above are met.

(e) The outpatient substance use disorder treatment program shall provide laboratory services directly in the program or shall ensure the availability of services through written affiliation agreements, as indicated in N.J.A.C. 10:161B-13.

N.J. Admin. Code § 10:66-2.6

Amended by 49 N.J.R. 1405(a), effective 6/5/2017