N.J. Admin. Code § 10:60-3.7 - Basis of payment for personal care assistant services

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

(a) Personal care assistant services shall be reimbursed on a per unit, fee-for-service basis for weekday, weekend, and holiday services. Nursing assessment and reassessment visits under this program shall be reimbursed on a per visit, fee-for-service basis.
(b) Personal care assistant services reimbursement rates (see N.J.A.C. 10:60-11 ) are all inclusive maximum allowable rates. No direct or indirect cost over and above the established rates may be considered for reimbursement. At all times the provider shall reflect its standard charge on the CMS 1500 Claim Form (see Fiscal Agent Billing Supplement, Appendix A, incorporated herein by reference) even though the actual payment may be different. A provider shall not charge the New Jersey Medicaid/NJ FamilyCare programs in excess of current charges to other payers.
(c) For reimbursement purposes only, a weekend means a Saturday or Sunday; a holiday means an observed agency holiday which is also recognized as a Federal or State holiday.

Notes

N.J. Admin. Code § 10:60-3.7
Amended by 50 N.J.R. 1992(b), effective 9/17/2018

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