N.J. Admin. Code § 10:77-3.3

Current through Register Vol. 56, No. 19, October 7, 2024

Section 10:77-3.3 - Provider participation requirements

(a) Requirements for participation as a mental health rehabilitation provider shall be as follows:

1. An applicant shall be licensed by the Department of Children and Families in accordance with N.J.A.C. 3A:55 or 3A:56 and shall provide mental health rehabilitation services.

2. A psychiatric community residence for youth or any other provider that is not enrolled as a provider of mental health personal care services by the Department of Children and Families in accordance with N.J.A.C. 3A:55 or 3A:56, shall enroll as a mental health rehabilitation provider.

3. All applicants shall complete and submit a provider application, including a copy of their license, to:

Division of Medical Assistance and Health Services

Office of Provider Enrollment, Mail Code #9

PO Box 712

Trenton, New Jersey 08625-0712

i. The applicant shall receive written notification of approval or disapproval of its provider status. If approved, the applicant shall be assigned a Provider Number, and shall receive a copy of this chapter.

ii. Upon approval as a Medicaid/NJ FamilyCare provider, the provider shall conform to all the provisions of N.J.A.C. 10:49, this chapter and any applicable rules of the Department of Children and Families.

4. A provider is required to enroll each site at which services are provided and obtain a separate provider number for each site.

5. In order to participate in the New Jersey Medicaid/NJ FamilyCare Program, a provider shall:

i. Have a valid National Provider Identifier (NPI) number obtained from the National Plan and Provider Enumeration System (NPPES);

ii. Have a valid taxonomy code obtained from the NPPES; and

iii. Remain a provider in good standing by successfully completing provider revalidation, when requested by DMAHS.

N.J. Admin. Code § 10:77-3.3

Amended by R.2002 d.401, effective 12/16/2002.
See: 34 N.J.R. 2709(a), 34 N.J.R. 4441(b).
Added new (a)4.
Amended by R.2003 d.90, effective 3/3/2003.
See: 34 N.J.R. 3467(a), 35 N.J.R. 1287(a).
In (a)3ii, substituted "FamilyCare" for "KidCare".
Amended by R.2008 d.251, effective 8/18/2008.
See: 40 N.J.R. 1040(a), 40 N.J.R. 4807(a).
In (a)1 and (a)2, substituted "Department of Human" for "Division of Mental Health" and "Department of Children and Families" for "Division of Youth and Family Services"; in (a)1, inserted a comma following "10:37B" and substituted "provide" for "be providing eligible"; in (a)2, deleted "currently" following "not" and "also" following "shall"; and in (a)3ii, inserted ", this chapter and any applicable rules of the Department of Children and Families".

Amended by 55 N.J.R. 1292(a), effective 6/19/2023