PROVIDERS
The Health Care Authority’s mission is: We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services.
Providers Overview
The Health Care Authority’s Medical Assistance Division oversees Medicaid provider enrollment, re-enrollment, and re-validation. Medical providers (including hospitals and private practitioners) and managed care organizations can find valuable provider resources here.
Find communications from the Medicaid director on the Communications to Providers web page.
Learn about the new Provider Enrollment and Presumptive Eligibility Determiner system, coming in November 2024.
Learn about Critical Incident Reporting requirements and protocols.
Learn how to become a Presumptive Eligibility Determiner to help eligible individuals enroll in Medicaid.
Find Fee-for-Service fee schedules and Medicaid services for Native Americans.
For questions or concerns, please contact the Consolidated Customer Service Center at 1-800-299-7304
Provider Type and Taxonomy Grid for Claim Submission
Home and Community Based providers who wish to serve members can find out more on the Agency Based Community Benefits (ABCB) Program web page and in the Medicaid Managed Care Policy Manual.
New Mexico Medicaid Portal
Providers can use the New Mexico Medicaid Portal to find information about policy & billing, claims submission, client eligibility, financial issues, Medicare, provider enrollment, third party liability, remittance advices and more.