New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 67 - PSYCHOLOGICAL SERVICES
Subchapter 2 - GENERAL PROVISIONS
Section 10:67-2.1 - General provisions
Current through Register Vol. 56, No. 18, September 16, 2024
(a) Psychological services reimbursed directly to the psychologist may be provided in settings such as an office, home, general hospital (inpatient), residential health care facility, nursing facility, or residential treatment center that is not enrolled as an approved Medicaid/NJ FamilyCare provider.
(b) The New Jersey Medicaid/NJ FamilyCare program will not reimburse for services supervised by, but not performed by the psychologist in any setting. Only the psychologist who personally renders the psychological service will be reimbursed.
(c) The special reimbursement for psychological services will be rendered if the provider meets the specialist requirements as defined in 10:67-1.2 and 1.3.
(d) Except for psychological testing or exceptional circumstances which are documented in the patient's medical record, only one psychological service shall be reimbursed per day for the same beneficiary by the same provider, group, shared health care facility, or practitioners sharing a common record.
(e) Payment for a psychological evaluation shall include all psychological services provided on that day. No additional reimbursement will be made for psychotherapy on the day that a psychological evaluation is provided.
(f) "Consultation" or "concurrent care" shall not be billed by a psychologist specialist for his or her services as a specialist. If a referral from a psychologist to a psychiatrist is indicated, the psychiatrist may be reimbursed under the provisions of "consultation" or "concurrent care" in the Physician Services Manual (N.J.A.C. 10:52) in addition to the psychologist bill, but not vice versa.
