New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 54 - PHYSICIAN SERVICES
Subchapter 4 - BASIS OF PAYMENT
Section 10:54-4.9 - Use of HCPCS codes for neonatal intensive care
Universal Citation: NJ Admin Code 10:54-4.9
Current through Register Vol. 56, No. 18, September 16, 2024
(a) For neonatal intensive care services to be covered by the Program, the codes HCPCS 99295-99297 shall be used and the service shall be consistent with the narrative in the CPT and with the following, in order to be reimbursed:
1. The patient's situation requires constant physician attendance which shall be given by the physician to the exclusion of his or her other patients and duties and, therefore, for him or her, represents what is beyond usual service. This must be verified by the applicable records, as defined by the setting. The records shall show in the physician's handwriting the time of onset and time of completion of the service.
(b) HCPCS codes 99295-99297 shall not be used simultaneously with procedure codes that pay a reimbursement for the same time or type of service.
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