New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 67 - PSYCHOLOGICAL SERVICES › Subchapter 1 - INTRODUCTION › Section 10:67-1.2 - Definitions

Current through Register Vol. 56, No. 14, July 15, 2024
The following words and terms, when used in this chapter,
				  shall have the following meanings unless the context clearly indicates
				  otherwise.
"CPT" means that edition of the Current Procedure Terminology
				  most current at the time of reference, as published annually by the American
				  Medical Association, Chicago, Illinois, unless otherwise specified in
				  rule.
"Face-to-face" means direct contact between the provider and
				  the patient during a treatment session, this shall include a telehealth
				  visit.
"National Plan and Provider Enumerations System (NPPES)"
				  means the system that assigns NPIs, maintains and updates information about
				  health care providers with NPIs, and disseminates the NPI Registry and the
				  NPPES Downloadable File. The NPI Registry is an online query system that allows
				  users to search for a health care provider's information.
"National Provider Identifier (NPI)" means a unique 10-digit
				  identification number issued to health care providers by the Centers for
				  Medicare and Medicaid Services (CMS).
"Nursing facility (NF)" means an institution (or distinct
				  part of an institution) certified by the New Jersey State Department of Health
				  and approved for participation in Medicaid/NJ FamilyCare and primarily engaged
				  in providing:
1. Nursing care and
				related services for patients who require medical, nursing care, and social
				services;
2. Rehabilitative
				services for the rehabilitation of the injured, disabled, or sick; or
3. Health-related care and services on a
				regular basis to patients who because of a mental or physical condition require
				care and services above the level of room and board. However, the nursing
				facility is not primarily for the care and treatment of patients with mental
				diseases which require continuous 24-hour supervision by qualified mental
				health professionals.
"Physician" means a doctor of medicine (M.D.), osteopathy
				  (D.O.) or podiatric medicine, licensed to practice medicine and surgery by the
				  New Jersey State Board of Medical Examiners, or similarly licensed by
				  comparable agencies of the state in which he or she practices.
"Psychological services" means those services rendered within
				  the scope of the profession of psychology as defined by the laws of the State
				  of New Jersey or by the laws of the state in which the psychologist
				  practices.
"Psychological specialist" means a psychologist who limits
				  his or her practice to his or her specialty and who:
1. Is a Diplomate of the American Board of
				Professional Psychology (Diplomate Qualified); or
2. Is eligible for or has been notified of
				admissibility to the examination by the American Board of Professional
				Psychology (Diplomate Eligible).
"Psychologist" means a practicing professional psychologist
				  who is licensed by the New Jersey State Board of Psychological Examiners or by
				  the comparable state agency in the state in which he or she practices.
"Residential health care facility" means a facility, licensed
				  by the New Jersey State Department of Health, which furnishes food and shelter
				  to four or more persons 18 years of age and older who are unrelated to the
				  owner and which provides dietary services, recreational activities, supervision
				  of self-administration of medications, supervision of and assistance in
				  activities of daily living (ADL), and assistance in obtaining health services
				  to one or more of such persons. As used in this chapter, the term "residential
				  health care facility" means a "boarding home for sheltered care" as defined by
				  the New Jersey State Department of Health.
"Residential treatment center" means a facility that:
1. Has a facility or program accreditation by
				the Joint Commission, or other accreditation as specified in the Department's
				rules;
2. Provides 24-hour per day
				care and treatment for recipients under 22 years of age whose needs are such
				that they are unable to function appropriately in their homes, schools and
				communities, and are not able to be served appropriately in less restrictive
				setting; and
3. Has signed a
				provider agreement to participate in the Medicaid/NJ FamilyCare program and
				abide by the rules of the Division.
"Taxonomy code" means a code that describes the provider or
				  organization's type, classification, and the area of specialization.
"Type 1 NPI" means a code that describes an individual
				  provider in the NPPES system.
"Type 2 NPI" means a code that describes an organizational
				  provider in the NPPES system.