MedicaidAdministrativeHigh impact
New Mexico Medicaid: State enrollment is required for claim payment
UnitedHealthcare·NM·State news
Effective date
Jul 1, 2026
We identified it
Jun 13, 2026
Summary
Starting July 1, 2026, New Mexico Medicaid will deny all claims where attending, referring, ordering, and prescribing providers are not enrolled with the state Medicaid program. All providers and pharmacists serving Medicaid members must register at yes.nm.gov before the deadline to avoid claim denials.
Action Required
Before July 1, 2026: All providers and pharmacists must enroll with New Mexico Medicaid at yes.nm.gov. Billing team must verify all attending, referring, ordering, and prescribing providers have valid NPI numbers and TIN on file. Update claims to include Payer ID 87748 (or 87726 for electronic visit verification claims). Contact HCA Provider Enrollment at 800-299-7304 or nm.providers@hca.nm.gov with questions. Failure to enroll will result in automatic claim denials for all New Mexico Medicaid services.