New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 67 - PSYCHOLOGICAL SERVICES
Subchapter 1 - INTRODUCTION
Section 10:67-1.5 - Basis of reimbursement
Current through Register Vol. 56, No. 18, September 16, 2024
(a) Psychological services shall be reimbursed at the lesser of the psychologist's charges or the amount in the Maximum Fee Allowance Schedule for psychological services. (See 10:67-3.2 for the Maximum Fee Allowance Schedule.)
(b) The Maximum Fee Allowance Schedule is based on the Healthcare Common Procedure Coding System (HCPCS). For HCPCS codes and Maximum Fee Allowance Schedule, see N.J.A.C. 10:67-3. For billing instructions, see the Fiscal Agent Billing Supplement. For instructions on how to obtain a copy of the Fiscal Agent Billing Supplement see the Appendix of this chapter.
(c) In no event shall the provider's charge to the New Jersey Medicaid/NJ FamilyCare program exceed the charge for services rendered by the provider for identical services to other governmental agencies, or other groups or individuals in the community.
