N.J. Admin. Code § 10:61-2.3 - Limitations on laboratory services

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

(a) Tests performed by a non-approved laboratory are not reimbursable. The referring laboratory shall verify approved status.
(b) Additional payment will not be made to a laboratory for obtaining specimens, except when performed in a long-term care facility, boarding home, or home.
(c) A laboratory shall be reimbursed only those tests that are within the specialty/subspecialty categories indicated in its CLIA approval.
(d) Laboratory services provided primarily for the diagnosis or treatment of infertility shall not be covered by the Medicaid/NJ FamilyCare program.
1. For those HCPCS procedure codes which are determined to be primarily for the diagnosis of infertility, refer to the HCPCS subchapter and the Indicator "F."

Notes

N.J. Admin. Code § 10:61-2.3

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