N.J. Admin. Code § 10:58-2.15

Current through Register Vol. 57, No. 1, January 6, 2025

Section 10:58-2.15 - Family planning services; Norplant System (NPS)

(a) The Norplant System (NPS) is a Medicaid/NJ FamilyCare covered service when provided as follows:

1. The NPS is used only in reproductive age women with established regular menstrual cycles;

2. The Food and Drug Administration (FDA)-approved physician prescribing information is followed; and

3. Patient education and counseling are provided relating to the NPS, including pre and post-insertion instructions, indications, contraindications, benefits, risks, side effects, and other contraceptive modalities.

(b) A CNM shall not be reimbursed separately for an office visit when that visit was solely for the purpose of the insertion or removal of an NPS device. A CNM shall be reimbursed for the NPS device and the insertion and/or removal of the appropriate procedure codes related to the NPS system (see N.J.A.C. 10:58-3.6(a) ).

(c) Only two insertions and two removals of the NPS per beneficiary shall be reimbursed during a five-year continuous period.

(d) The CNM shall not be reimbursed for the NPS in conjunction with other forms of contraception, for example, intrauterine device.

N.J. Admin. Code § 10:58-2.15

Amended by R.2001 d.204, effective 6/18/2001.
See: 33 N.J.R. 1160(a), 33 N.J.R. 2188(a).
In (a), inserted a reference to NJ FamilyCare; in (c), substituted "beneficiary" for "recipient".