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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.
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2 Responses
The reg does not say services need to be billed at the NY rate. Just says reimbursed at the lower rates. Very similar to the misnomer about Great Wall that acupuncture should be billed at the Chiro rate..
You are correct in the most technical sense. In reality, it will be the NY rate. The reason is clear. In prolific no-fault state’s with fee schedules (NY, NJ and Florida), NY is the lowest paying fee schedule. When compared with the other two prolific states that pop up on my radar (Michigan and now Minnesota), the former allows R & C and Minnesota requires payment of the billed amount!
Here is a challenge to anyone who has free time on their hands (I have so little) – give me a list of one of the frequently billed codes in any state where New York would pay more.