New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 75 - PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY SERVICES FOR INDIVIDUALS UNDER AGE 21
Subchapter 4 - REIMBURSEMENT
Section 10:75-4.2 - Billing procedures

Universal Citation: NJ Admin Code 10:75-4.2

Current through Register Vol. 56, No. 6, March 18, 2024

(a) Beginning on the date of admission, and for each subsequent whole day that a resident is under the care of the PRTF, the provider shall seek reimbursement using the appropriate HCPCS procedure code as defined in 10:75-5.2.

(b) Providers shall request reimbursement for services provided on the date that the resident adult is admitted to the facility, but shall not request reimbursement for services provided on the day that the resident is discharged from the facility. Discharged means that the resident has been discharged from the facility and is not reasonably expected to return to the facility.

(c) Providers may bill for consecutive dates of service on the same claim line, but shall not span dates from more than one month on any given claim lime. Therapeutic and hospital leave days shall be indicated on separate lines and reimbursement shall be requested using the appropriate HCPCS code, as defined in 10:75-5.2.

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