New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 66 - INDEPENDENT CLINIC SERVICES
Subchapter 4 - FEDERALLY QUALIFIED HEALTH CENTER (FQHC)
Section 10:66-4.2 - Hospital visits
Universal Citation: NJ Admin Code 10:66-4.2
Current through Register Vol. 56, No. 18, September 16, 2024
(a) An inpatient hospital visit performed by a clinic physician for a registered Medicaid or NJ FamilyCare fee-for-service patient of a Federally qualified health center shall be reimbursed only if the clinic is specifically approved to provide this service by the programs.
1. For a salaried
physician in a Federally qualified health center, an inpatient hospital visit
shall be billed by the FQHC as a medical encounter.
2. For a physician under contract with a
Federally qualified health center, the physician may receive reimbursement as
an individual provider as long as the clinic is not also billing for the same
service. The only contracted physician's costs that may be reported in the
FQHC's Medicaid cost report are for visits that are billed by the
FQHC.
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