New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 74 - MANAGED HEALTH CARE SERVICES FOR MEDICAID/NJ FAMILYCARE BENEFICIARIES
Subchapter 3 - BENEFITS
Section 10:74-3.10 - General Medicaid/NJ FamilyCare program exclusions
Universal Citation: NJ Admin Code 10:74-3.10
Current through Register Vol. 56, No. 18, September 16, 2024
(a) The following shall not be considered covered services in the capitation rate, if provided:
1. All claims arising directly or
indirectly from services provided by or in institutions owned or operated by
the Federal government;
2. Elective
cosmetic surgery;
3. Rest
cures;
4. Personal comfort and
convenience items; services and supplies not directly related to the care of
the patient, including, but not limited to, guest meals and accommodations,
telephone charges, travel expenses other than those services which may be
specifically covered under the standard benefits package (such as ambulance
services), take-home supplies and similar costs;
5. Services involving the use of equipment in
facilities, the purchase, rental or construction of which has not been approved
by applicable laws of the State of New Jersey and regulations issued pursuant
thereto;
6. Infertility treatment
services;
7. Services provided in
an inpatient psychiatric institution that is not an acute care hospital to
individuals under 65 years of age and over 21 years of age; and
8. Private duty nursing in an institution or
hospital setting and private duty nursing provided in any setting for
individuals 21 years of age or older.
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.