New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 76 - PROGRAMS OF ASSERTIVE COMMUNITY TREATMENT (PACT) SERVICES
Subchapter 1 - GENERAL PROVISIONS
Section 10:76-1.3 - Provider participation criteria
Current through Register Vol. 56, No. 6, March 18, 2024
(a) To participate in the Medicaid/NJ FamilyCare program, all providers shall be under contract with the Division of Mental Health and Addiction Services (DMHAS) as a provider of PACT services and shall meet the requirements set forth by the DMHAS related to PACT services in accordance with N.J.A.C. 10:37J.
(b) In order to participate in the Medicaid/NJ FamilyCare program, all applicants shall complete and submit the "Medicaid Provider Application" (FD-20) and the "Medicaid Provider Agreement" (FD-62), as well as a copy of their license provided by DHS, in accordance with N.J.A.C. 10:190, to:
Division of Medical Assistance and Health Services
Office of Provider Enrollment, Mail Code #9
PO Box 712
Trenton, New Jersey 08625-0712
(c) The applicant will receive written notification of approval or disapproval of Medicaid/NJ FamilyCare provider status from DMAHS. If approved, the applicant will be assigned a Medicaid/NJ FamilyCare Provider Number, and will receive a copy of this chapter as part of the provider manual.
(d) Prior to billing for PACT services, those who have previously enrolled, and are currently approved, as Medicaid/NJ FamilyCare providers in other categories of service, shall be required to enroll as a PACT provider by completing and submitted a new provider application and shall receive an additional, unique, provider identification number for submitting claims for the provision of PACT services.
(e) Upon approval as a Medicaid/NJ FamilyCare provider of PACT services, the provider shall conform to the provisions of this chapter and the provisions of N.J.A.C. 10:49, the Administration Manual for DMAHS programs.
(f) If a PACT provider loses its license from DHS, and is unable to provide services, the provider shall notify the Provider Enrollment Unit, at the address in (b) above, within five business days of losing the license.
(g) In order to participate in the New Jersey Medicaid/NJ FamilyCare Program, a PACT services provider shall: