Why Trust This Analysis
This article is part of our ongoing fee schedule coverage, with 118 published articles analyzing fee schedule issues across New York State. Attorney Jason Tenenbaum brings 24+ years of hands-on experience to this analysis, drawing from his work on more than 1,000 appeals, over 100,000 no-fault cases, and recovery of over $100 million for clients throughout Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, and the Bronx. For personalized legal advice about how these principles apply to your specific situation, contact our Long Island office at (516) 750-0595 for a free consultation.
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. The new 11 NYCRR 68.6 regulation will be published tomorrow and will be effect 1/8/18.
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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.
Legal Context
Why This Matters for Your Case
New York law is among the most complex and nuanced in the country, with distinct procedural rules, substantive doctrines, and court systems that differ significantly from other jurisdictions. The Civil Practice Law and Rules (CPLR) governs every stage of civil litigation, from service of process through trial and appeal. The Appellate Division, Appellate Term, and Court of Appeals create a rich and ever-evolving body of case law that practitioners must follow.
Attorney Jason Tenenbaum has practiced across these areas for over 24 years, writing more than 1,000 appellate briefs and publishing over 2,353 legal articles that attorneys and clients rely on for guidance. The analysis in this article reflects real courtroom experience — from motion practice in Civil Court and Supreme Court to oral arguments before the Appellate Division — and a deep understanding of how New York courts actually apply the law in practice.
About This Topic
Fee Schedule Issues in No-Fault Insurance
The New York no-fault fee schedule establishes the maximum reimbursement rates for medical treatment provided to injured motorists. Disputes over fee schedule calculations, coding, usual and customary charges, and the applicability of workers compensation fee schedules to no-fault claims are common. These articles analyze fee schedule regulations, court decisions on reimbursement disputes, and the practical challenges providers face in obtaining appropriate payment under the no-fault system.
118 published articles in Fee Schedule
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Disclaimer: This article is published by the Law Office of Jason Tenenbaum, P.C. for informational and educational purposes only. It does not constitute legal advice, and no attorney-client relationship is formed by reading this content. The legal principles discussed may not apply to your specific situation, and the law may have changed since this article was last updated.
New York law varies by jurisdiction — court decisions in one Appellate Division department may not be followed in another, and local court rules in Nassau County Supreme Court differ from those in Suffolk County Supreme Court, Kings County Civil Court, or Queens County Supreme Court. The Appellate Division, Second Department (which covers Long Island, Brooklyn, Queens, and Staten Island) and the Appellate Term (which hears appeals from lower courts) each have distinct procedural requirements and precedents that affect litigation strategy.
If you need legal help with a fee schedule matter, contact our office at (516) 750-0595 for a free consultation. We serve clients throughout Long Island (Huntington, Babylon, Islip, Brookhaven, Smithtown, Riverhead, Southampton, East Hampton), Nassau County (Hempstead, Garden City, Mineola, Great Neck, Manhasset, Freeport, Long Beach, Rockville Centre, Valley Stream, Westbury, Hicksville, Massapequa), Suffolk County (Hauppauge, Deer Park, Bay Shore, Central Islip, Patchogue, Brentwood), Queens, Brooklyn, Manhattan, the Bronx, Staten Island, and Westchester County. Prior results do not guarantee a similar outcome.
