New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 58A - ADVANCED PRACTICE NURSE SERVICES
Subchapter 1 - GENERAL PROVISIONS
Section 10:58A-1.1 - Introduction: certified advanced practice nurse (APN)

(a) This chapter is concerned with the provision of health care services by certified advanced practice nurses (APNs), in accordance with the New Jersey Medicaid and NJ FamilyCare fee-for-service programs' policies and procedures and the standards set forth by the New Jersey Legislature (45:11-23 et seq. and P.L. 1991, c. 377, as revised by P.L. 1999, c. 85) and by the New Jersey Board of Nursing (N.J.A.C. 13:37-7). Throughout this chapter, all use of the terms "advanced practice nurse" and "APN" refer to a certified advanced practice nurse because all advanced practice nurses are required to be certified.

(b) An approved New Jersey Medicaid/NJ FamilyCare fee-for-service APN provider may be reimbursed for medically necessary covered services provided within the scope of the APNs' license and an approved New Jersey Medicaid/NJ FamilyCare fee-for-service Program Provider Agreement.

(c) An APN may enroll in the New Jersey Medicaid/NJ FamilyCare fee-for-service program and provide covered, medically necessary services as an independent APN, or may provide such services as part of another entity, such as a hospital or clinic, physician group practice, or a mixed clinical practitioner practice.

(d) Unless otherwise stated, the rules of this chapter apply to Medicaid and NJ FamilyCare fee-for-service beneficiaries and to Medicaid and NJ FamilyCare fee-for-service services that are not the responsibility of the managed care organization (MCO) with which the beneficiary is enrolled. Advanced practice nurse services that are to be provided by the beneficiary's selected MCO are governed and administered by that MCO.