New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 56 - MANUAL FOR DENTAL SERVICES
Subchapter 1 - DENTAL SERVICES; GENERAL PROVISIONS
Section 10:56-1.6 - Reimbur sement based on specialist designation
Universal Citation: NJ Admin Code 10:56-1.6
Current through Register Vol. 56, No. 18, September 16, 2024
(a) To obtain reimbursement as a specialist in the Medicaid/NJ FamilyCare programs, a specialist shall:
1. Obtain a specialty certification from the licensing agency of the State of New Jersey or of the state where dental services are to be rendered; or
2. In those states not requiring specialty certification:
i. The specialist shall be a diplomate of a specialty board recognized by the American Dental Association or shall meet the minimum requirements for that specialty as stipulated by the American Dental Association.
(b) Any provider who meets the qualifications in (a) above and desires specialist reimbursement shall submit proof of specialist certification as described above to:
Unisys
Provider Enrollment Unit
PO Box 4801
Trenton, New Jersey 08650-4801
(c) Specialist reimbursement shall be limited to the following specialties:
1. Oral and Maxillofacial Surgery;
2. Endodontics;
3. Pedodontics--Pediatric Dentistry;
4. Orthodontics;
5. Periodontics; and/or
6. Prosthodontics.
Disclaimer: These regulations may not be the most recent version. New Jersey may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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