N.J. Admin. Code § 10:91-7.1

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

Section 10:91-7.1 - Fee schedule

(a) All services shall be provided with prior authorization from the Commission.

(b) The vendor shall provide to the client's caseworker a written report which details the services rendered by the vendor before payment is made.

(c) The Commission, in consultation with the necessary medical professionals, shall review exceptions to the Commission's medical fee schedule and establish non-listed fees on a case-by-case basis. In determining exceptions to the Commission's fee schedule, the Commission and the medical professionals shall consider factors such as, but not limited to:

1. The availability of a specific service within a client's geographic area; and

2. The uniqueness of the required medical procedure.

(d) A vendor who accepts Commission fees shall not charge the Commission client more than what the Commission fee is for a specific service as indicated in its fee schedule.

(e) The Commission's medical fee schedule follows:

Click here to view table

N.J. Admin. Code § 10:91-7.1

Amended by R.2000 d.313, effective 8/7/2000.
See: 32 New Jersey Register 1482(a), 32 New Jersey Register 2902(a).
In (d), rewrote 2, 9, 16, 18, 23 and 24, and increase corneal transplant tissue fee in 25.
Amended by R.2001 d.349, effective 10/1/2001.
See: 33 New Jersey Register 2066(a), 33 New Jersey Register 3449(a).
Inserted new (d); recodified former (d) as (e) with substantive changes.

Amended by 56 N.J.R. 777(a) effective 5/6/2024