N.J. Admin. Code § 10:77-5.10 - Authorization for services

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

(a) Intensive in-community mental health rehabilitation services shall be provided only in conjunction with other mental health treatment, rehabilitative and social support services as part of an individualized service plan authorized by the contracted system administrator or other authorized agent of the Department of Human Services or Children and Families.
(b) Effective for dates of service on or after January 1, 2004, intensive in-community mental health rehabilitation services included in the individual service plan of a Medicaid/NJ FamilyCare-Plan A child, youth, or young adult or any other NJ FamilyCare-Plan child, youth, or young adult who is receiving services under Children's System of Care programs shall be subject to prior authorization by the CSA.
(c) Authorization for service utilization and continuing care shall be determined by the CSA and shall be based upon the individual needs of the child, youth or young adult receiving services.
(d) Requests for authorization for service utilization and continuing care shall include justification of the need for the level of service intervention, the frequency of the intervention, and the period of time the intervention is needed. Such justification shall be provided for the initial request as well as for each request for continued services beyond the initial authorization.

Notes

N.J. Admin. Code § 10:77-5.10
Amended by 48 N.J.R. 81(a), effective 1/4/2016

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