New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 58 - NURSE MIDWIFERY SERVICES
Subchapter 1 - GENERAL PROVISIONS
Section 10:58-1.6 - Application for provider status; birth centers

Universal Citation: NJ Admin Code 10:58-1.6

Current through Register Vol. 56, No. 18, September 16, 2024

(a) A birth center shall enroll as a CNM provider in order to receive reimbursement for the use of the facility for labor and delivery services provided at the center.

(b) The birth center shall be licensed by the Department of Health in accordance with the provisions at N.J.A.C. 8:43A-28.

(c) In order to receive reimbursement for professional services provided by a CNM employed by the birth center, the birth center shall enroll as a CNM provider and the CNM employed by the birth center shall meet the provider requirements in 10:58-1.4(a).

(d) When a CNM not employed by a birth center provides professional services at the birth center as an independent provider, the CNM shall bill Medicaid/NJ FamilyCare directly for those professional services.

(e) The birth center shall complete the Medicaid/NJ FamilyCare Provider Application (FD-20), the Provider Agreement (FD-62) , and the Ownership and Control Interest and Disclosure Statement (CMS-1513).

1. The birth center shall include with the application a copy of its license, a list of all the CNMs employed by the center, together with their CNM Medicaid/NJ FamilyCare provider numbers, and copies of the CNMs' licenses. The application and all attachments shall be submitted to: Gainwell Technologies Provider Enrollment Mail Code #9 PO Box 4804 Trenton, NJ 08650-4804

2. Each CNM employed by the birth center shall have a provider servicing number. The birth center shall report this number when billing Medicaid/NJ FamilyCare for CNM services.

(f) For information regarding reimbursement for pre-natal and post natal care, see 10:58-2.16 and 3.6.

(g) Upon signing and returning the Medicaid/NJ FamilyCare Provider Application, the Provider Agreement and other enrollment documents to the New Jersey Medicaid/NJ FamilyCare programs, the birth center will receive written notification of approval or disapproval.

(h) Each approved birth center shall notify the New Jersey Medicaid/NJ FamilyCare programs a minimum of 30 days prior to the relocation or closing of its facilities.

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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