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.
Supplements to MAD NMAC Program Rules – 2026
| Supplement Numbers | Policy Topic | Date |
| 26-01 |
Permanent Supportive Housing and Tenancy Support Services (PSH-TSS)
|
January 26, 2026 |
Supplements to MAD NMAC Program Rules – 2025
| Supplement Numbers | Policy Topic | Date |
| 25-14 | Billing and Reimbursement for Traditional Health Care Practices (THCP) | December 19, 2025 |
| 25-13 | Birthing Options Program Billing and Reimbursement | December 18, 2025 |
| 25-12 | ICF/IID Annual UPL Supplemental Payment SPA 24-0009 | October 6, 2025 |
| 25-11 | Update to Prior Authorization Requests for High Power Prescription and Polycarbonate Lenses for Eligible Adults | September 22, 2025 |
| 25-10 | Implementation of Community Health Worker (CHW) and Community Health Representatives (CHR) Updates Per Repeal and Replace Letter of Direction | August 28, 2025 |
| 25-09 | Food is Medicine Benefit for Pregnant Recipients with Diabetes | July 30, 2025 |
| 25-08 | Billing and Reimbursement for Medical Respite Services for Individuals Experiencing Homelessness | May 28, 2025 |
| 25-07 |
Birthing Options Program Billing & Reimbursement
Replaces Supplement 19-02
|
May 21, 2025 |
| 25-06 |
Implementation of Certified Community Behavorial Health Clinics Replaces Supplement 24-22 |
April 21, 2025 |
| 25-05 | Implementing a New Place of Service (POS) 27, “Outreach Site/Street” | April 3, 2025 |
| 25-04 | National Drug Code (NDC) Requirements When Billing for Drug Items Administered in Practitioners’ Offices, Outpatient Clinics, and Hospitals and 340B Coding Requirements | February 12, 2025 |
| 25-03 | Qualified Clinical Trials (QTC) Information | February 4, 2025 |
| 25-02 | Billing and Reimbursement for Biomarkers | February 3, 2025 |
| 25-01 | Billing and Reimbursement for Doula Services | January 9, 2025 |
Supplements to MAD NMAC Program Rules – 2024
|
Supplement Numbers |
Policy Topic |
Date |
| 24-23 | Billing and Guidance for Lactation Care Providers in the Outpatient Setting | December 20, 2024 |
| 24-22 | Implementation of Certified Community Behavioral Health Clinics
See Updated Supplement 25-06 |
December 9, 2024 |
| 24-21 | Dental Procedure Code (D1354) – Application of Silver Diamine Fluoride Provided by Dental Providers | November 4, 2024 |
| 24-20 | Silver Diamine Fluoride (0792T) by a Physician or Other Qualified Health Care Professional | November 4, 2024 |
| 24-19 | Billing and Reimbursement Guidance for Comprehensive Addiction Recovery Act (CARA) Program-Plan of Safe Care in the Hospital Setting | October 23, 2024 |
| 24-18 | Billing and Reimbursement Guidelines for Chiropractic Services | October 23, 2024 |
| 24-17 | Billing and Coding Discarded or No Discarded Drugs and Biologicals with a JW or JZ Modifier | October 16, 2024 |
| 24-16 | Revised Medical Necessity Criteria for Orthodontic Treatment | October 16, 2024 |
| 24-15 | Coverage of Gender Affirming Healthcare Medications and Procedures | October 11, 2024 |
| 24-14 | Implementation of Mobile Crisis Intervention Services and Mobile Response and Stabilization
Replaces Supplement 24-03 |
October 7, 2024 |
| 24-13 | Applied Behavior Analysis (ABA) Guidance
Replaces 23-02 |
September 17, 2024 |
| 24-12 | Provider Payment Rate Changes for Intensive Outpatient Program (IOP) Services
Replaces 24-05 |
July 25, 2024 |
| 24-11 |
Provider Full Transition to Electronic Enrollment Requirements |
July 31, 2024 |
| 24-10 |
Human Donor Milk Billing and Guidance in Outpatient Setting |
July 9, 2024 |
| 24-09 |
Reimbursement for Tribal 638 Nursing Facilities |
June 25, 2024 |
| 24-08 |
Implementation of Community Health Workers (CHW) and Community Health Representatives (CHR) |
May 31, 2024 |
| 24-07 |
State Fiscal Year 2024 Behavioral Health Fee Schedule |
May 14, 2024 |
| 24-06 |
Repeal of Hepatitis C Virus (HCV) Checklist – and Elimination of Prior Authorization for Glecaprevir/Pibrentasivir (Mavyret®) and Sofosbuvir/Velpatasvir (Epclusa ®) Replaces Supplement 20-13 |
May 14, 2024 |
| 24-05 | Provider Payment Rate Changes for Intensive Outpatient Program (IOP) Services
See Updated Supplement 24-12 |
April 8, 2024 |
| 24-04 | Clarification on Billing for Nursing Facility Short-Term Stays | April 1, 2024 |
| 24-03 | Implementation of Mobile Crisis Intervention Services and Mobile Response and Stabilization
See Updated Supplement 24-14 |
March 18, 2024 |
| 24-02 | Implementation of High-Fidelity Wraparound Program Revised
Replaces Supplement 23-05 |
March 8, 2024 |
| 24-01 | Implementation of Behavioral Health Evidence-Based Practices | February 26, 2024 |
Supplements to MAD NMAC Program Rules – 2023
|
Supplement Numbers |
Policy Topic |
Date |
| 23-11 | Medical Aid in Dying (MAID) | November 6, 2023 |
| 23-10 | Annual Indigent Care Reporting Requirements | November 6, 2023 |
| 23-09 | Non-Emergency Transportation (NEMT) Referrals for Outside of the Home Community | September 5, 2023 |
| 23-08 | FFS Applied Behavioral Analysis Submission Process | September 5, 2023 |
| 23-07 | Changes to Claim Submittal Process and Rates for Abortion Procedures
Replaces Supplement 22-15 |
August 21, 2023 |
| 23-06 | Medicaid Billing for Human Donor Milk for Medicaid Eligible Recipients in Inpatient Hospital | August 9, 2023 |
| 23-05 | Implementation of High-Fidelity Wraparound Program
See Updated Supplement 24-02 |
August 9, 2023 |
| 23-04 | Suspension of Prior Authorization Requirements for Skilled Nursing, Long-Term Care, and Home Health Facilities/Agencies | April 17, 2023 |
| 23-03 | Suspension of Prior Authorization Requirements for Skilled Nursing, Long-Term Care, and Home Health Facilities/Agencies
Replaces Supplement 22-12 |
April 17, 2023 |
| 23-02 | Applied Behavior Analysis (ABA) Guidance
Replaces Supplement 22-02 – Revised |
April 13, 2023 |
| 23-01 | Upgrade to Comagine Health Provider Portal (CHPP) | March 29, 2023 |
Supplements to MAD NMAC Program Rules – 2021
| Supplement Numbers | Policy Topic | Date |
| 21-01 | Newborn Medicaid Program | March 17, 2021 |
| 21-02 | National Drug Code (NDC) and 340B Drug Rebates | April 9, 2021 |
| 21-03 | Home & Community Based Services – Supports Waiver Fee Schedule | May 10, 2021 |
| 21-04 | Tribal FQHC Designation and Billing Guidance | May 10, 2021 |
| 21-05 | ICF/IID Level of Care Procedures & Discharges | October 18, 2021 |
| 21-06 | I.H.S. Tribal 638 Outpatient Pharmacy Reimbursement | November 23, 2021 |
| 21-07 | Funding Sources and Presumptive Eligibility | November 23, 2021 |
Supplements to MAD NMAC Program Rules – 2020
| Supplement Numbers | Policy Topic | Date |
| Special COVID – 19 Supplement #3 | Guidance for New Mexico Medicaid Providers | April 6, 2020 |
| Special COVID -19 Supplement #16 | COVID-19 Vaccine Coverage, Billing and Reimbursement | August 16, 2021 |
| 20-07 | Changes to Billing Procedure and Reimbursement for Hospice Services | 28-Aug-20 |
| 20-08 | Medically Fragile Waiver Fee Schedule | 22-Sep-20 |
| 20-11 | Naturopathic Doctors: Participation in the New Mexico Medicaid Program | 10/23/2020 |
| 20-13 | Revised 8/30/2021 Uniform New Mexico Hepatitis C Virus Checklist – Repeal and Replace MAD 634 Form |
8/30/2021 |
Supplements to MAD NMAC Program Rules – 2019
| Supplement Numbers | Policy Topic | Date |
| 19-09 | Medicaid Billing for Long-Acting Reversible Contraception (LARC) Products Provided in an Inpatient Setting | 8/13/2019 |
Supplements to MAD NMAC Program Rules – 2018
| Supplement Numbers | Policy Topic | Date |
| 18-04 | See Updated Supplement 20-13 Notice of New Hepatitis C Virus (HCV) Treatment Requirements for Fee-for-Service (FFS) Medicaid Recipients |
4/17/2018 |
Supplements to MAD NMAC Program Rules – 2017
| Supplement Numbers | Policy Topic | Date |
| 17-07 | Requirements for Reporting Attending, Ordering, Referring, and Rendering Providers on Claims | September 11,2017 |
| 17-08 | Requirements for Reporting Ordering, Referring, and Rendering Providers on Claims | 9/11/2017 |
| 17-09 | Requirements for Reporting Rendering, Ordering, and Referring Providers on Claims | 9/11/2017 |
| 17-10 | Licensed Birth Centers | 10/26/2017 |
| 17-11 | Early Periodic Screening, Diagnostic, and Treatment (EPSDT)Screening Services | 11/15/2017 |
Supplements to MAD NMAC Program Rules – 2016
| Supplement Numbers | Policy Topic | Date |
| 16-11 | Billing for Medication Monitoring by RNs Group Therapy – Same Day Billing Clarification on Prolonged Service Assertive Community Treatment (ACT) Updates The Use of Provisional Diagnoses for the “Treat First” Clinical Model |
12/1/2016 |
| 16-13 | Billing and Payments to Federally Qualified Health Centers (FQHC), Rural Health Clinics (RHC), Hospital Based Rural Health Clinics (HB-RHC) and Indian Health Service (IHS) FQHCs | 1/6/2017 |
Supplements to MAD NMAC Program Rules – 2015
| Supplement Numbers | Policy Topic | Date |
| 15-04 |
Extension of Enhanced Payments for Primary Care Provider Services in 2015 and Beyond Primary Care Increase Self-Attestation Form – January 1, 2015 |
6/4/2015 |
2014 MAD Supplements
14-04 OPPS Hospital & Lab Supplement
2013 MAD Supplements
13 01 Increase in Payment Rates for Primary Care Provider Services & Vaccination Reimbursement
13 05 Supplement, Hysterectomy Consent Form
2012 MAD Supplements
2011 MAD Supplements
11 03 All Provider Notice on Multiple Topics
11 08 New Requirements when Billing Specific Procedure Codes
2010 MAD Supplements
10 04 Application Requirements and Coverage for Emergency Services for Aliens (EMSA)
10 07 Implementation of Hospital Outpatient Prospective Payment System
10 08 Implementation of Outpatient Hospital Prospective Payment System, Effective 11/1/2010
10 09 Anesthesia Services Regulation
10 11 Submitting Claims for Consideration of Timely Filing Limit Waiver
2009 Supplements
09 06 Early Periodic Screening Diagnostic and Treatment (EPSDT) Screening Services
2008 MAD Supplements
08 02 Medicaid Reimbursement for Birth Control & Family Planning Services
08 04 Dental Procedure Code D9920 – Behavior Management
2007 MAD Supplements
07 01 Preparing to Use National Provider Identifier (NPI) and NPI Deadlines
07 02 Corrections to the DD HCBS Waiver Rate Table
07 03 Using Taxonomy with the National Provider Identifier (NPI) and Deadlines
07 04 Increase in the Amount Allowed for Hearing Aids & Dispensing Fees
07 05 HCBS Waiver Provider Notice of Increases in Medicaid Reimbursement
07 06 Provider Notice of Increases in Medicaid Reimbursement
07 07 Personal Care Provider Notice – Increases in Medicaid Reimbursement
07 10 Using the “Notification of Birth” Form to Expedite Payment for Services to Newborns
2006 MAD Supplements
06 01Treatment at the Scene without Transport
2005 MAD Supplements
05 01 Binaural Hearing Aid Fitting
2004 MAD Supplements
04 10 Reimbursement for Hearing Aids