N.J. Admin. Code § 10:68-1.4

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

Section 10:68-1.4 - Application for provider status; chiropractor

(a) Any chiropractor may apply to the New Jersey Medicaid/NJ FamilyCare program for approval as a provider, if he or she is a chiropractor licensed by the State Board of Chiropractic Examiners in accordance with N.J.A.C. 13:44E, or licensed by a comparable state agency in the state in which the chiropractor practices.

(b) See N.J.A.C. 10:49-3for additional requirements for provider participation.

(c) An applicant shall complete a Provider Application (FD-20; see N.J.A.C. 10:49, Appendix #8) and a Provider Agreement (FD-62; see N.J.A.C. 10:49, Appendix #9). The forms may be obtained from, and shall be submitted to:

Gainwell Technologies

Provider Enrollment

PO Box 4804

Trenton, NJ 08650-4804

(d) The application and agreement shall be accompanied by a photocopy of the applicant's current license as a chiropractor.

(e) The applicant will receive notification of approval or disapproval from the Division's fiscal agent. If approved, the chiropractor shall be furnished with a provider manual and assigned a Division provider identification number. The chiropractor shall use the assigned provider identification number on all billing documents submitted to the Division's fiscal agent.

N.J. Admin. Code § 10:68-1.4

Amended by R.2000 d.451, effective 11/6/2000.
See: 32 N.J.R. 2691(a), 32 N.J.R. 3992(b).
In (a), added "or, NJ KidCare" preceding "program"; in (a) and (c), deleted "Medicaid" preceding "provider" and "Provider" throughout; in (e) substituted "Division's" for "Medicaid" preceding "fiscal agent"; and substituted "Division" for "Medicaid" preceding "provider identification".
Amended by R.2006 d.416, effective 12/4/2006.
See: 38 N.J.R. 2012(a), 38 N.J.R. 5157(a).
In (a), substituted "FamilyCare" for "KidCare".

Amended by 53 N.J.R. 1788(a), effective 10/18/2021