New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 58 - NURSE MIDWIFERY SERVICES
Subchapter 3 - CENTERS FOR MEDICARE & MEDICAID SERVICES CMS HEALTHCARE COMMON PROCEDURE CODING SYSTEM HCPCS
Section 10:58-3.5 - HCPCS Procedure Codes (Level III) and maximum fee allowance schedule for certified nurse midwifery services
Universal Citation: NJ Admin Code 10:58-3.5
Current through Register Vol. 56, No. 18, September 16, 2024
| HCPCS | Follow-up | Maximum Fee | |||
|---|---|---|---|---|---|
| IND | Codes | MOD | Days | Descriptions | Allowance |
| (a) Intrauterine Devices: | |||||
| W0001 | WM | 30 | Supplying and inserting the | $ 304.00 | |
| intrauterine device "Paragard" by a CNM | |||||
| including the post-insertion visit. | |||||
| W0002 | WM | 30 | Supplying and inserting the | $ 137.00 | |
| intrauterine device "Progestasert" by a | |||||
| CNM including the post-insertion visit. | |||||
| W0004 | WM | 30 | Removal of an IUD by a CNM followed at | $ 317.00 | |
| the same visit by the insertion of the | |||||
| intrauterine device "Paragard" by a CNM | |||||
| including the post-insertion visit. | |||||
| W0008 | WM | 30 | Removal of an IUD by a CNM followed at | $ 150.00 | |
| the same visit by the insertion of the | |||||
| intrauterine device "Progestasert" by a | |||||
| CNM including the post-insertion visit. | |||||
| (b) HealthStart: | |||||
| N | W9025 | WM | HealthStart Initial Antepartum | 67.00 | |
| Maternity Medical Care Visit by | |||||
| Certified Nurse Midwife | |||||
| N | W9026 | WM | HealthStart Subsequent Antepartum | 19.00 | |
| Maternity Medical Care Visit by | |||||
| Certified Nurse Midwife | |||||
| N | W9027 | WM | HealthStart Regular Delivery by | 371.00 | |
| Certified Nurse Midwife | |||||
| N | W9028 | WM | HealthStart Postpartum Care Visit by | 19.00 | |
| Certified Nurse Midwife | |||||
| N | W9029 | WM | HealthStart Regular Delivery and | 390.00 | |
| Postpartum Visit by Certified Nurse | |||||
| Midwife | |||||
| N | W9030 | WM | HealthStart Total Obstetrical Care by | 723.00 | |
| Certified Nurse Midwife | |||||
| (c) Injections: | |||||
| (d) EPSDT: | |||||
| N | W9820 | WM | Early and Periodic Screening, Diagnosis | 18.00 | |
| and Treatment (EPSDT) from 2 through 20 | |||||
| years of age | |||||
| (e) Maternity Care: | |||||
| N | W9855 | WM | Initial Visit Antepartum Visit by | 15.40 | |
| Certified Nurse Midwife | |||||
| N | W9856 | WM | Subsequent Antepartum Visit by | 11.20 | |
| Certified Nurse Midwife | |||||
| (f) Delivery Services: | |||||
| Z0250 | WM | Home Delivery Pack (All drugs and | 40.00 | ||
| supplies, etc. necessary for delivery | |||||
| in this setting.) | |||||
| (g) Birth Centers Facility Fee: | |||||
| W9858 | Birth Center Services, global | 1,300.00 | |||
| W9859 | Birth Center Services, limited | 500.00 | |||
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