Current through Register Vol. 56, No. 18, September 16, 2024
(a) The services
listed below are available to beneficiaries eligible for NJ FamilyCare-Plan I,
on a fee-for-service basis, when medically necessary:
1. Advanced practice nurse
services;
2. Clinic services
(services in an independent outpatient health care facility, other than a
hospital, that provides covered ambulatory care services);
3. Emergency room services;
4. Family planning services including medical
history and physical examination (including pelvic and breast), diagnostic and
laboratory tests, drugs and biologicals, medical supplies and devices,
counseling, continuing medical supervision, continuity of care and genetic
counseling.
i. Services provided primarily for
the diagnosis and treatment of infertility, including sterilization reversals,
and related office (medical and clinic) visits, drugs, laboratory services,
radiological and diagnostic services and surgical procedures shall not be
covered by the NJ FamilyCare program;
5. Federally qualified health center primary
care services;
6. Home health care
services, limited to skilled nursing for a home bound beneficiary which is
provided or supervised by a registered nurse, and home health aid services when
the purpose of the treatment is skilled care; medical social services which are
necessary for the treatment of the beneficiary's medical condition; and
short-term physical, speech or occupation therapy with the same limitations
described in (a)21 below;
i. Personal care
assistant services are not covered;
7. Hospice services;
8. Hospital services--inpatient;
9. Hospital services--outpatient;
10. Laboratory (clinical);
11. Nurse-midwifery services;
12. Optometric services, including one
routine eye examination per year;
13. Optical appliances, limited to one pair
of glasses or contact lenses per 24 month period;
14. Organ transplant services which are
non-experimental or non-investigational;
15. Prescription drug services, except that
over-the-counter drugs are not covered;
16. Physician services;
17. Podiatric services, except that routine
foot care is not covered;
18.
Prosthetic appliances, limited to initial provision of prosthetic device that
temporarily or permanently replaces all or part of an external body part lost
or impaired as a result of disease or injury or congenital defect;
i. Coverage includes repair and replacement
when due to congenital growth;
19. Private duty nursing only when authorized
by DMAHS;
20. Radiological
services;
21. Outpatient
rehabilitative services, including physical, occupational and speech therapy
for non-chronic conditions and acute illnesses and injuries. Outpatient
rehabilitation benefits are limited to treatment over a period of 60
consecutive business days per incident of illness or injury beginning with the
first day of treatment, except that:
i.
Speech therapy services rendered for treatment of delays in speech development,
unless resulting from disease, injury or congenital defects are not
covered;
22. Inpatient
rehabilitation services, including physical, occupational and speech therapy
for non-chronic conditions and acute illnesses and injuries;
23. Transportation services, limited to
ambulance for medical emergency only;
24. Maternity and related newborn
care;
25. Diabetic supplies and
equipment;
26. Services for mental
health or behavioral conditions;
i. Inpatient
hospital services, including psychiatric hospitals, limited to 35 days per
year;
ii. Outpatient benefits for
short-term, outpatient evaluative and crisis intervention or home health mental
health services, limited to 20 visits per year. When authorized by the Division
of Medical Assistance and Health Services, inpatient benefit exchanges are
allowed, as follows:
(1) One mental health
inpatient day may be exchanged for up to four home health visits or four
outpatient services, including partial care. This is limited to an exchange of
up to a maximum of 10 inpatient days for a maximum of 40 additional outpatient
visits.
(2) One mental health
inpatient day may be exchanged for two days of treatment in partial
hospitalization up to the maximum number of covered inpatient days.
iii. Inpatient and outpatient
services for substance abuse are limited to detoxification;
iv. Adult mental health rehabilitation
services provided in/by community residence programs (see N.J.A.C. 10:77A) are
not eligible for payment under NJ FamilyCare-Plan I; and
v. NJ FamilyCare-Plan I beneficiaries under
age 21 who are receiving services under the Division of Child Behavior Health
Services, may be eligible for additional mental health and mental health
rehabilitation services as authorized by the Contracted Systems Administrator.
(See 10:49-5.10(c);
and
27. Elective/induced
abortion services.
(b)
Unless listed in (a) above, no other services shall be covered by NJ
FamilyCare-Plan I. Services which shall not be covered include, but shall not
be limited to:
1. Services that are not
medically necessary;
2. Private
duty nursing, unless prior authorized by the Division;
3. Intermediate care facilities for mental
retardation (ICF/MR);
4. Personal
care assistant services;
5. Medical
day care services;
6. Chiropractic
services;
7. Dental
services;
8. Orthotic
devices;
9. Targeted case
management for the chronically ill;
10. Christian Science sanitaria care and
services;
11. Durable medical
equipment;
12. Routine
transportation, including non-emergency ambulance, invalid coach and lower mode
(car, taxi, bus) transportation;
13. Hearing aid services;
14. Blood and blood plasma, except that
administration, processing of blood, processing fees and fees related to
autologous blood donations shall be covered;
15. Cosmetic services;
16. Nursing facility (long term care)
services;
17. Special and remedial
educational services;
18.
Experimental and investigational services;
19. Infertility services;
20. Medical supplies, except that diabetic
supplies shall be a covered service;
21. Rehabilitative services for substance
abuse (methadone maintenance is not covered);
22. Weight reduction programs or dietary
supplements;
23. Acupuncture and
acupuncture therapy, except when performed as a form of anesthesia in
connection with covered surgery;
24. Temporomandibular joint disorder (TMJ)
treatment, including treatment performed by prosthesis placed directly in the
teeth;
25. Recreational
therapy;
26. Sleep
therapy;
27. Court ordered
services;
28. Thermograms and
thermography;
29.
Biofeedback;
30. Radial
keratomy;
31. Respite
care;
32. Custodial care;
33. EPSDT services; and
34. Adult mental health rehabilitation
services provided in/by community residence programs (see N.J.A.C.
10:77A).
(c) Additional
mental health and mental health rehabilitation services as listed below shall
be available to beneficiaries under age 21 who are eligible for NJ
FamilyCare-Plan I under fee-for-service receiving services from the Division of
Child Behavioral Health Services. All services shall first be authorized by the
Contracted Systems Administrator or other agent authorized by the Department of
Human Services and shall be included in an approved plan of care.
1. Care coordination by a care management
organization (CMO) (see N.J.A.C. 10:73);
2. Psychiatric services provided in an
inpatient psychiatric hospital setting (see N.J.A.C. 10:52);
3. Mental health rehabilitation services
provided in residential childcare facilities (as defined in N.J.A.C. 10:127 and
licensed by DHS/DYFS), children's group homes (as defined in N.J.A.C. 10:128
and licensed by DHS/DYFS), or psychiatric community residences for youth (as
defined in N.J.A.C. 10:37B and licensed by DHS/DMHS);
4. Behavioral assistance services for
children, youth or young adults (see N.J.A.C. 10:77-4);
5. Mobil response and stabilization
management services for children, youth or young adults under EPSDT (see
N.J.A.C. 10:77-6); and
6.
Intensive in-community mental health rehabilitation services for children,
youth or young adults under EPSDT (see N.J.A.C. 10:77-5).