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MedicaidBilling CodesMedium impact

Supplement 25-13: Birthing Options Program Billing and Reimbursement

New Mexico Medicaid·NM · OB-GYN·Claims & Billing
Effective date
Jan 1, 2026
We identified it
Jun 21, 2026
Days to comply

Summary

New Mexico Medicaid has updated billing procedures for the Birthing Options Program, establishing a split billing model for licensed birth centers and standardizing reimbursement for midwife services. Birth centers will bill facility charges using UB/837I format with specific revenue codes, while professional services continue using CMS 1500/837P format.

Action Required

Action needed
By January 1, 2026: Billing teams for licensed birth centers and midwife providers in New Mexico must implement split billing model - update billing software to use UB/837I format with revenue codes 0724/0729 for facility charges and CMS 1500/837P for professional services. Ensure MAD 318 Confirmation/Release Statement is attached to all claims. Update encounter forms with new procedure codes and billing requirements for home births vs. birth center deliveries.

Affected Billing Codes

59400
59410
59610
59614
S4005
59899
99070
J2790
90384