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NJ S982
Bill
Status
1/9/2024
Primary Sponsor
Kristin Corrado
Click for details
AI Summary
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Health insurance carriers must use the federal Centers for Medicare and Medicaid Services' resource-based relative value scale (RBRVS) to determine reimbursement for evaluation and management billing codes (CPT codes 99202-99499) when appended with modifier 25
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Modifier 25 applies when a patient requires a significant, separately identifiable evaluation and management service beyond another procedure performed by the same provider on the same day
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The requirement applies to all insurance companies, health service corporations, HMOs, and includes the State Health Benefits Program and School Employees' Health Benefits Program
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The law takes effect 90 days after enactment and applies to policies delivered, issued, executed, or renewed after that date
Legislative Description
Requires health insurance carriers to use federal resource-based relative value scale when determining reimbursement values for evaluation and management billing codes appended by modifier 25.
Commerce
Last Action
Introduced in the Senate, Referred to Senate Commerce Committee
1/9/2024