Payor
New Jersey PIP
Rubrica tracks 10 sourced coverage rules across 10 CPT codes for New Jersey PIP — covering interventional spine, pain management, ortho spine, and orthopedics. Plan type(s): auto_pip. 1-state regional policy (sample: nj).
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Every Rubrica record cites a specific New Jersey PIP policy document with last-reviewed date and (where available) verbatim source text. Aggregate coverage breakdown by procedure category is shown below; full payor-specific criteria require sign-in.
Coverage by category
New Jersey PIP's coverage stance across procedure categories tracked in the Rubrica catalog.
| Category | Rules | Covered | Prior auth | Investigational |
|---|---|---|---|---|
| Spine Surgery | 5 | 5 | 5 | 0 |
| Arthroplasty — Hip | 1 | 1 | 1 | 0 |
| Arthroplasty — Knee | 1 | 1 | 1 | 0 |
| Arthroplasty — Shoulder | 1 | 1 | 1 | 0 |
| Arthroscopy — Knee | 1 | 1 | 1 | 0 |
| Arthroscopy — Shoulder | 1 | 1 | 1 | 0 |
Top tracked procedures
First 15 CPT codes in the New Jersey PIP catalog. Sign in for verbatim criteria, source links, and the rest of the catalog.
| CPT | Procedure | Coverage |
|---|---|---|
27447 | Total Knee Arthroplasty (TKA) | Covered |
27130 | Total Hip Arthroplasty (THA) | Covered |
23472 | Total Shoulder Arthroplasty (TSA / Reverse TSA) | Covered |
29827 | Arthroscopic Rotator Cuff Repair | Covered |
29888 | Arthroscopic ACL Reconstruction | Covered |
22551 | ACDF — Anterior Cervical Discectomy and Fusion | Covered |
22612 | PLF — Posterior Lumbar Fusion (Posterolateral) | Covered |
22558 | ALIF — Anterior Lumbar Interbody Fusion | Covered |
63030 | Laminotomy with Disc Excision — Lumbar | Covered |
63047 | Laminectomy with Facetectomy and Foraminotomy — Lumbar | Covered |
See every policy for New Jersey PIP.
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