New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 1 - GENERAL PROVISIONS › Section 10:77-1.1 - Purpose and scope

Current through Register Vol. 56, No. 14, July 15, 2024
(a) This chapter is concerned with the
				provision of, and reimbursement for, medically necessary Medicaid/NJ FamilyCare
				fee-for-service covered rehabilitative services, specifically, environmental
				lead inspection and hazard assessment services and mental health rehabilitation
				services for children, youth, and young adults, in accordance with the New
				Jersey Medicaid/NJ FamilyCare fee-for-service program rules, including those
				mental health rehabilitation services provided under the auspices of the
				Department of Children and Families' (DCF) Children's System of Care
				(CSOC).
(b) Medically necessary
				services shall meet all applicable State and Federal Medicaid and State
				Children's Health Insurance Program (SCHIP) laws, and all applicable rules as
				specified in the appropriate provider services manual of the New Jersey
				Medicaid/NJ FamilyCare program. The SCHIP program in New Jersey is known as NJ
				FamilyCare.
(c) The chapter is
				divided into seven subchapters and an appendix, as follows:
1.
										N.J.A.C.
				10:77-1 contains general provisions to
				rehabilitative services, including introductory general provisions and general
				definitions;
2.
										N.J.A.C.
				10:77-2 contains definitions, provisions for
				provider participation, basis for reimbursement, policies and procedures, and
				recordkeeping requirements pertaining to the specific Medicaid/NJ
				FamilyCare-Plan A-covered rehabilitative service: environmental lead inspection
				service;
3.
										N.J.A.C.
				10:77-3 contains definitions, provisions for
				provider participation, basis for reimbursement, policies and procedures, and
				recordkeeping requirements pertaining to the specific mental health
				rehabilitation services provided in psychiatric community residences for youth,
				group homes, or residential childcare facilities, available to children, youth,
				or young adults who are Medicaid/NJ FamilyCare beneficiaries or children,
				youth, or young adults who are ineligible for Medicaid/NJ FamilyCare but are
				receiving mental health rehabilitation services under DCF/CSOC.
4.
										N.J.A.C.
				10:77-4 contains the definitions, provisions
				for provider participation, basis for reimbursement, policies and procedures,
				and recordkeeping requirements pertaining to the specific Medicaid/NJ
				FamilyCare-covered mental health rehabilitation service of behavioral
				assistance services available to children, youth, or young adults who are
				Medicaid/NJ FamilyCare beneficiaries or children, youth, or young adults who
				are ineligible for Medicaid/NJ FamilyCare but are receiving mental health
				rehabilitation services under DCF/CSOC.
5.
										N.J.A.C.
				10:77-5 contains the definitions, provisions
				for provider participation, basis for reimbursement, policies and procedures,
				and recordkeeping requirements pertaining to the specific Medicaid/NJ
				FamilyCare-covered mental health rehabilitation service of intensive
				in-community services; available to children, youth, or young adults who are
				Medicaid/NJ FamilyCare beneficiaries or children, youth, or young adults who
				are ineligible for Medicaid/NJ FamilyCare but are receiving mental health
				rehabilitation services under DCF/CSOC.
6.
										N.J.A.C.
				10:77-6 contains the definitions, provisions
				for provider participation, basis for reimbursement, policies and procedures,
				and recordkeeping requirements pertaining to the specific Medicaid/NJ
				FamilyCare-Plan A-covered mobile response and stabilization management services
				for children; available to children, youth, or young adults who are Medicaid/NJ
				FamilyCare beneficiaries or children, youth, or young adults who are ineligible
				for Medicaid/NJ FamilyCare but are receiving mental health rehabilitation
				services under DCF/CSOC.
7.
										N.J.A.C.
				10:77-7 pertains to the Centers for Medicare
				and Medicaid Services' Healthcare Common Procedure Coding System (HCPCS). The
				HCPCS contains procedure codes and maximum fee allowances corresponding to the
				Medicaid/NJ FamilyCare and CSOC reimbursable services of this chapter;
				and
8. The chapter Appendix
				pertains to the Fiscal Agent Billing Supplement. The Fiscal Agent Billing
				Supplement contains billing instructions and samples of forms (claim forms,
				prior authorization forms, and consent forms) used in the billing
				process.