The State of New Jersey
 NJ Department of Banking and Insurance
search  

Home > Insurance Division > PIP Information for Health Care Providers
PIP Information for Health Care Providers
Find information regarding...
Automobile Medical Fee Schedule PIP Alternate Dispute Resolution
Uniform Attending Provider Treatment Plan Form Prompt Payment Regulation Information
N.J.A.C. 11:3-4 Medical Protocols Rule
(Care Paths, Decision Point Review, Precertification)		 Reference/Superceded Materials
21-Day Notice Rule  
 
Notice of Adopted New Rules, Amendments and Repeals - Personal Injury Protection
Order A12-118: In the Matter of the Request of the New Jersey Association for Justice for a Stay of the Adoption of Amendments and New Rules, N.J.A.C. 11:3-4.2, Et Seq.
Order A12-117: In the Matter of the Request of the United Acupuncture Society of New Jersey for a Stay of the Adoption of Amendments to N.J.A.C. 11:3-29 Appendix, Exhibit 6
Order A12-116: In the Matter of the Request of the New Jersey Coalition for Quality Healthcare for a Stay of the Adoption of Amendments and New Rules, N.J.A.C. 11:3-4.2, Et Seq.
Order A12-114: In the Matter of the Request for a Stay of the Adoption of Amendments and New Rules, N.J.A.C. 11:3-4.2, et seq.
Notice of Adoption that appeared in 11/05/12 New Jersey Register
Document showing all changes to text of rules from Proposal, Notice of Substantial Change and Adoption
top of page
Automobile Medical Fee Schedule

Auto Medical Fee Schedule Rule and Exhibits - Effective for Treatment rendered on or after August 10, 2009
Fee Schedule Rule Text - PDF or MS Word (Effective for treatment rendered on or after August 10, 2009)
Exhibit 1 Physicians' Fee Schedule - PDF or MS Excel (Effective for treatment rendered on or after August 10, 2009)
Exhibit 2 Dental Fee Schedule - PDF or MS Excel (Effective for treatment rendered on or after July 6, 2009)
Exhibit 3 Home Care Services - PDF or MS Excel (Effective for treatment rendered on or after June 15, 2009)
Exhibit 4 Ambulance Services - PDF or MS Excel (Effective for treatment rendered on or after August 10, 2009)
Exhibit 5 Durable Medical Equipment - PDF or MS Excel (Effective for treatment rendered on or after August 10, 2009)
Exhibit 6 CPT Codes Subject to Daily Maximum - PDF or MS Excel (Effective for treatment rendered on or after August 10, 2009)
Exhibit 7 Ambulatory Surgical Center Fee Schedule - PDF or MS Excel (Effective for treatment rendered on or after August 10, 2009)
 
Auto Medical Fee Schedule Rule and Exhibits - Effective for treatment rendered on or after January 4, 2013
Fee Schedule Rule Text - PDF or MS Word (Effective for treatment rendered on or after January 4, 2013)
Exhibit 1 Physicians' and ASC Fee Schedule - PDF or MS Excel (Effective for treatment rendered on or after January 4, 2013)
Exhibit 2 Dental Fee Schedule - PDF or MS Excel (Effective for treatment rendered on or after January 4, 2013)
Exhibit 3 Home Care Services - PDF or MS Excel (Effective for treatment rendered on or after January 4, 2013)
Exhibit 4 Ambulance Services - PDF or MS Excel (Effective for treatment rendered on or after January 4, 2013)
Exhibit 5 Durable Medical Equipment - PDF or MS Excel (Effective for treatment rendered on or after January 4, 2013)
Exhibit 6 CPT Codes Subject to Daily Maximum - PDF or MS Excel (Effective for treatment rendered on or after January 4, 2013)
Exhibit 7 Hospital Outpatient Surgical Facility (HOSF) Fee Schedule - PDF or MS Excel (Effective for treatment rendered on or after January 4, 2013)

Automobile Medical Fee Schedule Frequently Asked Questions (for rule effective January 4, 2013)
Proposed Substantial Changes to Medical Fee Schedule Rule - Comment period ended
Proposed Amendments to Medical Fee Schedule Rule (August 2011) - Comment period ended
Order A10-113: In Re the Use of the Ingenix MDR Database for the Calculation of Usual, Customary and Reasonable Fees Pursuant to N.J.A.C. 11:3-29.4(e)
Bulletin 09-26: Auto Medical Fee Schedule Rule Implementation
Automobile Medical Fee Schedule Frequently Asked Questions (for rule effective August 10, 2009)
Appellate Division Case: In Re Adoption of N.J.A.C. 11:3-29 by State of New Jersey, Department of Banking and Insurance (August 10, 2009)
N.J.A.C. 11:3-27: Order of Benefit Determination Between Automobile Insurance Personal Injury Protection and Health Insurance
top of page
Uniform Attending Provider Treatment Plan Form
All providers treating PIP patients must use the Uniform Attending Provider Plan Form to submit Decision Point and Precertification Requests to Insurers.
Uniform Attending Provider Treatment Plan Form - PDF or MS Excel
List of Auto Insurers and web sites
Frequently Asked Questions
Order A04-143
top of page
N.J.A.C. 11:3-4 Medical Protocols Rule (Care Paths, Decision Point Review, Precertification)
Full Text of Medical Protocols Rule
(Effective January 4, 2013, except as noted in the rule text)		  
Full Text of Medical Protocols Rule (Effective July 6, 2010)
Registered PIP Vendors
Full text of Medical Protocols Rule Appendix
Adopted Amendments to Medical Protocols Rule (November 5, 2012)
Proposed Substantial Changes upon Adoption to Medical Protocols Rule - Comment period ended
Bulletin 12-03: Withdrawal of Bulletin No. 10-22
Proposed Amendments to Medical Protocols Rule (August 2011) - Comment period ended
Adopted Amendments to Medical Protocols Rule (July 2010)
Implementation of Protocols Rule Amendments FAQs
top of page
21-Day Notice Rule
Text of 21-Day Notice Rule
List of Insurer Addresses to Send the Form
top of page
PIP Alternate Dispute Resolution

Full Text of Alternate Dispute Resolution Rule (Effective January 4, 2013)
Administrator Quarterly Reports
2013 2012
1st Quarter 1st Quarter
  2nd Quarter
  3rd Quarter
  4th Quarter
   
2011 2010
1st Quarter 1st Quarter
2nd Quarter 2nd Quarter
3rd Quarter 3rd Quarter
4th Quarter 4th Quarter
more

 
Full Text of Alternate Dispute Resolution Rule (Effective July 2010)
Notice of Administrative Correction 11:3-5.6 (February 4, 2013)
Adopted Amendments to PIP Alternate Dispute Resolution Rule (November 5, 2012)
Proposed Substantial Changes to Alternate Dispute Resolution Rule - Comment period ended
Proposed Amendments to PIP Alternate Dispute Resolution Rule (August 2011) - Comment period ended
Bulletin 10-30: Interpretation of DOBI Rules on PIP Reimbursements
Adopted Amendments to PIP Alternate Dispute Resolution Rule (June 2009)
Notice to the Bar Concerning the Participation of Insurance Company Employees in PIP Arbitrations (March 18, 2009)

PIP ADR Administrator: Forthright
Certified Medical Review Organizations
top of page
Prompt Payment Regulation Information
Prompt Pay Statute (N.J.S.A. 39:6A-5g)
top of page
Reference/Superceded Materials
More information
top of page
 
OPRA
 OPRA is a state law that was enacted to give the public greater access to government records maintained by public agencies in New Jersey.
line
Adobe Acrobat
 You will need to download the latest version of Adobe Acrobat Reader in order to correctly view and print PDF (Portable Document Format) files from this web site.
state seal
Copyright © 2011, State of New Jersey
New Jersey Department of Banking and Insurance