New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 54 - PHYSICIAN SERVICES
Subchapter 3 - PROVISION OF SERVICES
Section 10:54-3.3 - Authorization of reimbursement for out-of-State hospital services
Universal Citation: NJ Admin Code 10:54-3.3
Current through Register Vol. 56, No. 18, September 16, 2024
(a) A request for authorization for reimbursement for out-of-State hospital services shall be directed to the Medical Assistance Customer Center (MACC) in the area where the beneficiary resides (see N.J.A.C. 10:49, Appendix), except that:
1. Prior authorization of out-of-State psychiatric services shall be directed to the Office of Utilization Management, Mental Health Services Unit, and shall comply with the requirements of 10:54-7.4.
(b) If authorized, the authorization letter of a medical consultant of the New Jersey Medicaid/NJ FamilyCare program will be forwarded to the attending physician and the Medicaid/NJ FamilyCare program beneficiary. When submitting the claim for service to the Medicaid/NJ FamilyCare fiscal agent, the physician shall enter the authorization number on the claim.
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