New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 49 - ADMINISTRATION MANUAL
Subchapter 5 - SERVICES COVERED BY MEDICAID AND THE NJ FAMILYCARE PROGRAMS
Section 10:49-5.1 - Requirements for provision of services
Universal Citation: NJ Admin Code 10:49-5.1
Current through Register Vol. 56, No. 18, September 16, 2024
(a) The services listed in 10:49-5.2 are available to beneficiaries eligible for the regular New Jersey Medicaid or the NJ FamilyCare-Plan A programs. Services available to Medically Needy beneficiaries are listed in 10:49-5.3. The services listed in 10:49-5.2 and 5.3 shall be provided in conjunction with program requirements specifically outlined in the second chapter of each Provider Services Manual.
1. Any service limitations imposed will be
consistent with the medical necessity of the patient's condition as determined
by the attending physician or other practitioner and in accordance with
standards generally recognized by health professionals and promulgated through
the New Jersey Medicaid program. Some services require prior authorization from
the program before the services are provided (see N.J.A.C. 10:49-6
--Authorization Required).
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