New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 54 - PHYSICIAN SERVICES
Subchapter 4 - BASIS OF PAYMENT
Section 10:54-4.5 - Use of HCPCS codes for established patient visits
Universal Citation: NJ Admin Code 10:54-4.5
Current through Register Vol. 56, No. 18, September 16, 2024
(a) This rule applies to office, inpatient or outpatient services to established patients (excluding preventive health care for patients through 20 years of age).
(b) "Routine visit" or "follow-up visit" means the care and treatment by a physician, which includes those procedures ordinarily performed during a health care visit, which is dependent upon the setting and the physician's discipline. The setting may be an office, hospital, nursing facility or residential health care facility.
1. In order to receive reimbursement for a routine visit or follow-up visit, the documentation requirements set forth in 10:54-2.3 shall be met, regardless of where the examination was performed.
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