New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 22 - HEALTH BENEFIT PLANS
Subchapter 9 - MATERNITY INSTALLMENT PAYMENTS
Section 11:22-9.2 - Definitions
The following words and terms, when used in this subchapter, shall have the meanings as set forth below unless the context clearly indicates otherwise:
"CPT" means the American Medical Association's Current Procedural Terminology (CPT) maintained by the American Medical Association (AMA). CPT is a code set that accurately describes medical, surgical, and diagnostic services and is designed to communicate uniform information about medical services and procedures among physicians, coders, patients, accreditation organizations, and payers for administrative, financial, and analytical purposes.
"Health benefits plan" means an individual or group contract which pays hospital and medical expense benefits or provides hospital and medical services, and is delivered or issued for delivery in this State by or through a carrier.
"Health insurance carrier" or "carrier" means an insurance company, medical service corporation, health service corporation and health maintenance organization authorized to issue health benefits plans in this State.
"Maternity services" means prenatal care (office visits and screening tests), labor and delivery services (including hospitalization) and postpartum/postnatal care (routine hospital and outpatient visits following delivery).
"Obstetrical provider" or "provider" means an obstetrician/gynecologist licensed by the State Board of Medical Examiners or a midwife licensed by the State Board of Medical Examiners as a certified midwife or a certified nurse midwife.
