New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 57 - PODIATRY SERVICES
Subchapter 2 - PROVISION OF SERVICES
Section 10:57-2.7 - Clinical laboratory services
Current through Register Vol. 56, No. 18, September 16, 2024
(a) "Clinical laboratory services" means professional and technical laboratory services performed by a clinical laboratory certified by the Centers for Medicare & Medicaid Services (CMS) in accordance with the Clinical Laboratory Improvement Act (CLIA) and ordered by a physician or other licensed practitioner, within the scope of his or her practice as defined by the laws of the State of New Jersey and/or of the state in which the practitioner practices.
(b) Clinical laboratory services are furnished by clinical laboratories and by physician office laboratories (POLs) that meet the CMS regulations pertaining to clinical laboratory services defined in the Clinical Laboratory Improvement Amendments Act (CLIA) of 1988; 1902(a)(9) of the Social Security Act; 42 U.S.C. 1396 a (a)(9); and as indicated at 10:61-1.2, the Medicaid/NJ FamilyCare program's Independent Clinical Laboratory Services chapter.
(c) All independent clinical laboratories and other entities performing clinical laboratory testing shall possess certification as required by CLIA 1988, and the New Jersey Department of Health rules found at N.J.A.C. 8:44 and 8:45.
(d) A podiatrist may claim reimbursement for clinical laboratory services performed for his or her own patients within his or her own office, subject to the following:
(e) When the clinical laboratory test is performed on site, the venipuncture shall not be reimbursable as a separate procedure; its cost is included within the reimbursement for the lab procedure.
(f) When a podiatrist refers a laboratory test to an independent clinical reference laboratory: