Subchapter 4 - BASIS OF PAYMENT

  1. § 10:54-4.1 - General payment methodology
  2. § 10:54-4.2 - Personal contribution to care requirements for NJ FamilyCare-Children's Program-Plan C and copayments for NJ FamilyCare-Plan D
  3. § 10:54-4.3 - Use of physician reimbursement codes
  4. § 10:54-4.4 - HCPCS codes for new patients visits
  5. § 10:54-4.5 - Use of HCPCS codes for established patient visits
  6. § 10:54-4.6 - Use of HCPCS codes for home visits and house calls
  7. § 10:54-4.7 - Use of HCPCS codes for emergency department services
  8. § 10:54-4.8 - Use of HCPCS codes for critical care services
  9. § 10:54-4.9 - Use of HCPCS codes for neonatal intensive care
  10. § 10:54-4.10 - Use of HCPCS codes for neonatal care; well baby
  11. § 10:54-4.11 - Use of HCPCS codes for neonatal care; sick newborn
  12. § 10:54-4.12 - Physician reimbursement in special situations
  13. § 10:54-4.13 - HCPCS codes for surgical procedures; general
  14. § 10:54-4.14 - Pre-surgery consultation and evaluation
  15. § 10:54-4.15 - Simultaneous visit and other procedures
  16. § 10:54-4.16 - Multiple surgical procedures; same session
  17. § 10:54-4.17 - Repeat or revisitation of the surgical procedure
  18. § 10:54-4.18 - Ligation or transection of fallopian tubes
  19. § 10:54-4.19 - Anesthesiology
  20. § 10:54-4.20 - Radiology; general
  21. § 10:54-4.21 - Radiology; diagnostic imaging and ultrasound
  22. § 10:54-4.22 - Radiology; Computerized Tomography (CT), Magnetic Resonance Imaging (MRI) and Ultrasound
  23. § 10:54-4.23 - Nuclear medicine; diagnostic and therapeutic radiopharmaceuticals
  24. § 10:54-4.24 - Radiation oncology; treatment planning and therapy
  25. § 10:54-4.25 - Radiology; portable and mobile diagnostic
  26. § 10:54-4.26 - Consultation services; general
  27. § 10:54-4.27 - Consultation; limited
  28. § 10:54-4.28 - Consultation; comprehensive
  29. § 10:54-4.29 - Consultation; follow-up
  30. § 10:54-4.30 - Consultation; use of all consultation codes
  31. § 10:54-4.31 - Concurrent care; physicians
  32. § 10:54-4.32 - Concurrent care/collaboration with an APN
  33. § 10:54-4.33 - Services provided in a birthing center

The following state regulations pages link to this page.



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.