Chapter 52 - HOSPITAL SERVICES MANUAL

  1. Subchapter 1 - GENERAL PROVISIONS (§ 10:52-1.1 to 10:52-1.18)
  2. Subchapter 2 - POLICIES AND PROCEDURES RELATED TO SPECIFIC SERVICES (§ 10:52-2.1 to 10:52-2.16)
  3. Subchapter 3 - HEALTHSTART-MATERNITY AND PEDIATRIC CARE SERVICES (§ 10:52-3.1 to 10:52-3.17)
  4. Subchapter 4 - BASIS OF PAYMENT FOR HOSPITAL SERVICES (§ 10:52-4.1 to 10:52-4.9)
  5. Subchapter 5 - PROCEDURAL AND METHODOLOGICAL REGULATIONS (§ 10:52-5.1 to 10:52-5.21)
  6. Subchapter 6 - FINANCIAL REPORTING PRINCIPLES AND CONCEPTS (§ 10:52-6.1 to 10:52-6.79)
  7. Subchapter 7 - DIAGNOSIS RELATED GROUPS (DRG) (§ 10:52-7.1 to 10:52-7.3)
  8. Subchapter 8 - GRADUATE MEDICAL EDUCATION AND INDIRECT MEDICAL EDUCATION (§ 10:52-8.1 to 10:52-8.6)
  9. Subchapter 9 - REVIEW AND APPEAL OF RATES (§ 10:52-9.1)
  10. Subchapter 10 - CENTERS FOR MEDICARE & MEDICAID SERVICES HEALTHCARE COMMON PROCEDURE CODING SYSTEM (HCPCS) FOR HOSPITAL OUTPATIENT LABORATORY SERVICES (§ 10:52-10.1 to 10:52-10.5)
  11. Subchapter 11 - CHARITY CARE (§ 10:52-11.1 to 10:52-11.17)
  12. Subchapter 12 - CHARITY CARE COMPONENT OF THE DISPROPORTIONATE SHARE HOSPITAL SUBSIDIES (§ 10:52-12.1 to 10:52-12.3)
  13. Subchapter 13 - ELIGIBILITY FOR AND BASIS OF PAYMENT FOR DISPROPORTIONATE SHARE HOSPITALS (§ 10:52-13.1 to 10:52-13.7)
  14. Subchapter 14 - METHODOLOGY FOR ESTABLISHING DRG PAYMENT RATES FOR INPATIENT SERVICES AT GENERAL ACUTE CARE HOSPITALS BASED ON DRG WEIGHTS AND A STATEWIDE BASE RATE (§ 10:52-14.1 to 10:52-14.17)
  15. Appendix A - , version 8
  16. Appendix B - , version 7

Notes

CHAPTER SOURCE AND EFFECTIVE DATE:
R.2018 d.104, effective April 16, 2018.
See: 49 N.J.R. 3294(a), 50 N.J.R. 1261(a).
CHAPTER HISTORICAL NOTE:
Chapter 52, Manual for Hospital Services, was adopted as R.1971 d.30, effective March 5, 1971. See: 3 N.J.R. 24(b), 3 N.J.R. 62(c).
Subchapter 3, Teleprocessing Procedures, was adopted as R.1975 d.230, effective August 1, 1975. See: 7 N.J.R. 316(b), 7 N.J.R. 431(b).
Pursuant to Executive Order No. 66(1978), Subchapter 1, Coverage, was readopted as R.1984 d.47, effective February 9, 1984. See: 15 N.J.R. 2125(a), 16 N.J.R. 424(b).
Pursuant to Executive Order No. 66(1978), Subchapter 2, Admissions and Billing Procedures, was readopted as R.1985 d.56, effective January 28, 1985. See: 16 N.J.R. 3159(a), 17 N.J.R. 451(a).
Pursuant to Executive Order No. 66(1978), Chapter 52, Manual for Hospital Services, was readopted as R.1990 d.157, effective February 8, 1990. See: 21 N.J.R. 3911(a), 22 N.J.R. 799(b).
Subchapter 4, HCFA Common Procedure Coding System (HCPCS), was adopted as R.1992 d.327, effective August 17, 1992, operative September 1, 1992. See: 24 N.J.R. 917(a), 24 N.J.R. 2898(a).
Subchapter 5, Procedural and Methodological Regulations, Subchapter 6, Financial Reporting Principles and Concepts, Subchapter 7, Diagnosis Related Groups (DRG), Subchapter 8, Basis of Specific Payment for Disproportionate Share Hospitals, and Subchapter 9, Review and Appeal of Rates, were adopted as Emergency New Rules R.1993 d.154, effective March 11, 1993, to expire May 10, 1993. See: 25 N.J.R. 1582(a). The provisions of R.1993 d.154 were readopted as R.1993 d.263, effective May 10, 1993, with changes effective June 7, 1993. See: 25 N.J.R. 1582(a), 25 N.J.R. 2560(a).
Pursuant to Executive Order No. 66(1978), Chapter 52, Manual for Hospital Services, was readopted as R.1995 d.123, effective February 3, 1995. As a part of R.1995 d.123, Chapter 52 was renamed Hospital Services Manual, and Subchapter 1, Coverage, Subchapter 2, Admission and Billing Procedures, Subchapter 3, Teleprocessing Procedures, and Subchapter 4, HCFA Common Procedure Coding System (HCPCS), were repealed, and Subchapter 1, General Provisions, Subchapter 2, Policies and Procedures Related to Specific Services, Subchapter 3, Healthstart--Maternity and Pediatric Services, Subchapter 4, Basis of Payment for Hospital Services, and Subchapter 11, HCFA Common Procedure Coding System (HCPCS) for Hospital Outpatient Laboratory Services, were adopted as new rules, effective April 17, 1995. See: 26 N.J.R. 4551(a), 27 N.J.R. 1660(a).
Subchapter 10, Charity Care, was adopted as R.1995 d.258, effective May 15, 1995. See: 27 N.J.R. 656(a), 27 N.J.R. 1995(a).
Subchapter 12, Graduate Medical Education and Indirect Medical Education, was adopted as R.1997 d.43, effective January 21, 1997. See: 28 N.J.R. 4022(a), 29 N.J.R. 350(b).
Subchapter 10A, Charity Care Component of the Disproportionate Share Hospital Subsidies, was adopted as R.1997 d.520, effective January 5, 1998. See: 29 N.J.R. 1006(a), 30 N.J.R. 232(a).
Pursuant to Executive Order No. 66(1978), Chapter 52, Hospital Services Manual, was readopted as R.2000 d.29, effective December 21, 1999, and Subchapter 8, Basis of Specific Payment for Disproportionate Share Hospitals, was recodified as Subchapter 13, Eligibility for and Basis of Payment for Disproportionate Share Hospitals, Subchapter 10, Charity Care, was recodified as Subchapter 11, Charity Care, Subchapter 10A, Charity Care Component of the Disproportionate Share Hospital Subsidies, was recodified as Subchapter 12, Charity Care Component of the Disproportionate Share Hospital Subsidies, Subchapter 11, HCFA Common Procedure Coding System (HCPCS) for Hospital Outpatient Laboratory Services, was recodified as Subchapter 10, HCFA Common Procedure Coding System (HCPCS) for Hospital Outpatient Laboratory Services, and Subchapter 12, Graduate Medical Education and Indirect Medical Education, was recodified as Subchapter 8, Graduate Medical Education and Indirect Medical Education, by R.2000 d.29, effective January 18, 2000. See: 31 N.J.R. 3151(a), 32 N.J.R. 276(a).
Chapter 52, Hospital Services Manual, was readopted as R.2005 d.214, effective June 9, 2005. See: 37 N.J.R. 436(a), 37 N.J.R. 2506(a).
Subchapter 14, Methodology for Establishing DRG Payment Rates for Inpatient Services at General Acute Care Hospitals Based on DRG Weights and a Statewide Base Rate, was adopted as new rules by R.2009 d.249, effective August 3, 2009. See: 41 N.J.R. 1351(a), 41 N.J.R. 2895(a).
Chapter 52, Hospital Services Manual, was readopted as R.2011 d.010, effective December 6, 2010. As a part of R.2011 d.010, Subchapter 10, HCFA Common Procedure Coding System (HCPCS) for Hospital Outpatient Laboratory Services, was renamed Centers for Medicare & Medicaid Services Healthcare Common Procedure Coding System (HCPCS) for Hospital Outpatient Laboratory Services, effective January 3, 2011. See: 42 N.J.R. 1656(a), 43 N.J.R. 43(a).
In accordance with N.J.S.A. 52:14B-5.1b, Chapter 52, Hospital Services Manual, was scheduled to expire on December 6, 2017. See: 43 N.J.R. 1203(a).
Chapter 52, Hospital Services Manual, was readopted as R.2018 d.104, effective April 16, 2018. See: Source and Effective Date. See, also, section annotations.

CHAPTER AUTHORITY:

N.J.S.A. 30:4D-1 et seq., and 30:4J-8 et seq.

State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.