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.

This New Jersey bill (S 3264) requires health insurance companies to use the federal Medicare/Medicaid resource-based relative value scale (RBRVS) when setting payment rates for specific doctor visits. It specifically applies to evaluation and management services (coded 99202-99499) that include modifier 25, which identifies a significant, separate visit occurring on the same day as another procedure. The law mandates that insurers base reimbursement payments on the federal RBRVS system, which calculates rates based on the resources needed to deliver care. This affects all health insurance carriers in New Jersey and directly impacts healthcare providers who bill for these specific types of visits.