New Mexico Medicaid: State enrollment is required for claim payment
AI Summary
Effective July 1, 2026, New Mexico Medicaid will deny claims when attending, referring, ordering, and prescribing providers are not enrolled with the state Medicaid program. All providers and pharmacists must register at yes.nm.gov before the effective date to avoid claim denials.
Action Required
Before July 1, 2026: All providers and pharmacists must enroll with New Mexico Medicaid by visiting yes.nm.gov and following HCA enrollment instructions. Billing team must verify all attending, referring, ordering, and prescribing providers have valid NPI numbers and TIN on file. Include Payer ID 87748 (or 87726 for electronic visit verification) on all claims. Contact HCA Provider Enrollment at 800-299-7304 with questions. Failure to enroll will result in automatic claim denials for all New Mexico Medicaid services.
Plan Types
Medicaid
States
NM
Specialties
all-specialties