Defendant New Jersey Manufacturers appeals an order requiring it to reimburse an ambulatory surgical center (ASC) for a Current Procedural Terminology (CPT) code. The Department of Banking and Insurance's medical fee schedule listed the designation "N-1" for this CPT code, meaning it could be performed at an ASC but was "not separately reimbursable because the service [was] included in another procedure." In accord with N.J. Manufacturers Ins. Co. v. Specialty Surgical Center, 458 N.J. Super. 63 (App. Div. 2019), the court holds that the insurer was not required to reimburse the ASC for this CPT code, even though Medicare would permit reimbursement, because the Department's fee schedule did not list any payment amount for the code.
