Key Takeaway
New Jersey implements crucial no-fault insurance fee schedule regulation 68.6 in 2018, addressing long-standing billing inconsistencies and overbilling practices.
New Jersey No-Fault Fee Schedule Reform: Regulation 68.6 Implementation
New Jersey’s no-fault insurance system has long struggled with billing inconsistencies and disputes over medical fee schedules. The state’s approach to regulating healthcare provider billing under no-fault coverage has been a source of ongoing tension between insurers, healthcare providers, and attorneys representing injured parties. Unlike New York’s more structured no-fault insurance framework, New Jersey’s system has operated with certain regulatory gaps that have created opportunities for billing disputes and potential abuse.
The implementation of a new regulation 68.6 represents a significant step toward bringing order to this chaotic landscape. This type of regulatory reform typically addresses specific billing codes, reimbursement rates, and procedural requirements that healthcare providers must follow when submitting claims under no-fault coverage. Such regulations are essential for maintaining the integrity of the no-fault system and ensuring that legitimate medical expenses are covered while preventing fraudulent or excessive billing practices.
Jason Tenenbaum’s Analysis:
Rationality has finally reached us with the crazy New Jersey situation. This will be published tomorrow and will be effect 1/8/18.
Over billing beware.
This regulation should have come out years ago. I am grateful that it finally has been approved. Now, CPM and other rental items need to be addressed, as that loop hole remains open.
Key Takeaway
The new regulation 68.6 marks a crucial development in New Jersey’s no-fault insurance oversight, finally addressing billing irregularities that have persisted for years. While this reform closes significant gaps in fee schedule regulation, practitioners should note that issues with continuous passive motion (CPM) devices and other rental equipment remain unresolved, suggesting future regulatory attention may be needed in these areas.
Related Articles
- Cross-border medical fee schedules between New York and New Jersey
- Understanding medical billing and down-coding in New York no-fault insurance claims
- Fee schedule defense requirements in no-fault insurance cases
- Fee schedule competent evidence requirements
- New York No-Fault Insurance Law
Legal Update (February 2026): New Jersey’s Regulation 68.6, which took effect in January 2018, has undergone several amendments and updates since its initial implementation. The fee schedules, billing codes, and reimbursement rates referenced in this 2017 post have been subject to periodic revisions through regulatory updates and administrative changes. Practitioners should verify current provisions of N.J.A.C. 11:3-29 and related no-fault billing regulations, as specific fee amounts and procedural requirements may have been modified since the original regulation’s effective date.
