New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 61 - INDEPENDENT CLINICAL LABORATORIES
Subchapter 1 - GENERAL PROVISIONS
Section 10:61-1.5 - Medicare-Medicaid relationship

Universal Citation: NJ Admin Code 10:61-1.5

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

(a) Upon approval as an independent laboratory provider for Title XIX Medicaid participation and reimbursement, the requirements for independent laboratory services under the Title XVIII Medicare program shall be followed.

(b) A laboratory approved for Medicaid/NJ FamilyCare participation shall only provide services and be reimbursed for the specialties and subspecialties specifically approved for Medicare participation.

(c) State, county and municipal laboratories located in New Jersey may qualify for Medicaid/NJ FamilyCare reimbursement provided they meet the criteria in 10:61-1.4 and 1.5.

(d) Any entity that performs diagnostic tests in connection with its provider practice shall comply with this chapter and shall have a CLIA Identification Number to perform clinical laboratory testing reimbursable by the Medicaid/NJ FamilyCare program. A CLIA Identification Number must be on file with the Medicaid/NJ FamilyCare program before payment is made for any laboratory testing.

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