New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 66 - INDEPENDENT CLINIC SERVICES
Subchapter 2 - PROVISION OF SERVICES
Section 10:66-2.16 - Termination of pregnancy
Universal Citation: NJ Admin Code 10:66-2.16
Current through Register Vol. 56, No. 18, September 16, 2024
(a) Termination of pregnancy is a Medicaid and NJ FamilyCare fee-for-service-covered service when the following conditions are present:
1. The
procedure is performed in an appropriately licensed ambulatory care facility,
an ambulatory surgical center, or an ambulatory care/family planning/surgical
facility licensed and authorized by the New Jersey State Department of Health
to perform terminations of pregnancy with specific approval of the New Jersey
Medicaid or NJ FamilyCare program;
2. The procedure is performed in accordance
with the requirements of the New Jersey Board of Medical Examiners, N.J.A.C.
13:35;
3. The procedure is
performed by a physician licensed to practice medicine and surgery in the State
of New Jersey; and
4. The procedure
is medically necessary. A physician may take the following factors into
consideration in determining whether a termination of pregnancy is medically
necessary:
i. To save the life of the
mother;
ii. The pregnancy was the
result of an act of rape;
iii. The
pregnancy was the result of an act of incest;
iv. Physical, emotional, and psychological
factors;
v. Family reasons;
and
vi. Age.
(b) Claims for termination of pregnancy services are hard-copy restricted; electronic billing is not permitted.
(c) A Physician Certification (Form FD-179) shall be completed, signed and attached to any Medicaid or NJ FamilyCare fee-for-service claim form relating to termination of pregnancy services.
1. The Fiscal Agent
Billing Supplement contains a sample Physician Certification (Form FD-179) and
item-by-item instructions for the form's proper completion.
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.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
