This bill mandates that health insurance carriers in New Jersey utilize the federal resource-based relative value scale established by the Centers for Medicare and Medicaid Services when determining reimbursement values for evaluation and management billing codes that are appended by modifier 25. The bill defines key terms such as "carrier," "evaluation and management billing codes," "modifier 25," "reimbursement value," and "resource-based relative value scale" to clarify the scope and application of the legislation.
The act is set to take effect 90 days after its enactment and will apply to all health insurance policies or contracts that are delivered, issued, executed, or renewed on or after that effective date. By establishing this requirement, the bill aims to standardize reimbursement values for evaluation and management services provided by healthcare professionals, ensuring that they are compensated fairly based on the resources required to deliver these services.