N.J. Admin. Code § 10:58-3.5 - HCPCS Procedure Codes (Level III) and maximum fee allowance schedule for certified nurse midwifery services

Current through Register Vol. 54, No. 7, April 4, 2022

HCPCS Follow-up Maximum Fee
IND Codes MOD Days Descriptions Allowance
(a) Intrauterine Devices:
W0001 WM 30 Supplying and inserting the $ 304.00
intrauterine device "Paragard" by a CNM
including the post-insertion visit.
W0002 WM 30 Supplying and inserting the $ 137.00
intrauterine device "Progestasert" by a
CNM including the post-insertion visit.
W0004 WM 30 Removal of an IUD by a CNM followed at $ 317.00
the same visit by the insertion of the
intrauterine device "Paragard" by a CNM
including the post-insertion visit.
W0008 WM 30 Removal of an IUD by a CNM followed at $ 150.00
the same visit by the insertion of the
intrauterine device "Progestasert" by a
CNM including the post-insertion visit.
(b) HealthStart:
N W9025 WM HealthStart Initial Antepartum 67.00
Maternity Medical Care Visit by
Certified Nurse Midwife
N W9026 WM HealthStart Subsequent Antepartum 19.00
Maternity Medical Care Visit by
Certified Nurse Midwife
N W9027 WM HealthStart Regular Delivery by 371.00
Certified Nurse Midwife
N W9028 WM HealthStart Postpartum Care Visit by 19.00
Certified Nurse Midwife
N W9029 WM HealthStart Regular Delivery and 390.00
Postpartum Visit by Certified Nurse
Midwife
N W9030 WM HealthStart Total Obstetrical Care by 723.00
Certified Nurse Midwife
(c) Injections:
(d) EPSDT:
N W9820 WM Early and Periodic Screening, Diagnosis 18.00
and Treatment (EPSDT) from 2 through 20
years of age
(e) Maternity Care:
N W9855 WM Initial Visit Antepartum Visit by 15.40
Certified Nurse Midwife
N W9856 WM Subsequent Antepartum Visit by 11.20
Certified Nurse Midwife
(f) Delivery Services:
Z0250 WM Home Delivery Pack (All drugs and 40.00
supplies, etc. necessary for delivery
in this setting.)
(g) Birth Centers Facility Fee:
W9858 Birth Center Services, global 1,300.00
W9859 Birth Center Services, limited 500.00

Notes

N.J. Admin. Code § 10:58-3.5
Amended by R.1998 d.209, effective 5/4/1998.
See: 30 N.J.R. 57(a), 30 N.J.R. 1613(a).
Rewrote the section.
Amended by R.2001 d.204, effective 6/18/2001.
See: 33 N.J.R. 1160(a), 33 N.J.R. 2188(a).
Rewrote (a) and (c).
Amended by R.2006 d.338, effective 9/18/2006.
See: 38 N.J.R. 2003(a), 38 N.J.R. 3900(a).
In (c), deleted table.

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