New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 74 - MANAGED HEALTH CARE SERVICES FOR MEDICAID/NJ FAMILYCARE BENEFICIARIES
Subchapter 3 - BENEFITS
Section 10:74-3.4 - Fee-for-service program services requiring MCO assistance to Medicaid/NJ FamilyCare-Plans A, B, C, and D enrollees to access the services

1. Personal care assistant services (not covered for Medicaid/NJ FamilyCare-Plans B, C, and D unless enrolled in MLTSS);

2. Medical day care (not covered for Medicaid/NJ FamilyCare-Plans B, C, and D unless enrolled in MLTSS);

3. Outpatient rehabilitation services, including physical, occupational, and speech/language therapy;

4. Elective/induced abortions and related services, including surgical procedure, cervical dilation, insertion of cervical dilator, anesthesia including para cervical block, history and physical exam on day of surgery; PT, PTT, OB panel of lab tests, pregnancy test, urinalysis and urine drug screen, glucose and electrolytes; routine venipuncture, ultrasound, pathological examination of aborted fetus; Rhogam and its administration;

5. Transportation, lower mode;

6. Sex abuse examinations;

7. Services provided by DHS mental health/substance abuse residential facilities or group homes;

8. Family planning services and supplies when furnished by a non-MCO-participating provider;

9. Home health agency services for the aged, blind and disabled; and

10. Prescription drugs (legend and non-legend covered by the Medicaid/NJ FamilyCare program) for the aged, blind, or disabled.