MedicaidCoverageMedium impact
Supplement 25-08: Billing and Reimbursement for Medical Respite Services for Individuals Experiencing Homelessness
New Mexico Medicaid·NM · Family Medicine·Claims & Billing
Effective date
Jun 1, 2025
We identified it
Jun 21, 2026
Summary
New Mexico Medicaid is adding coverage for medical respite services for homeless individuals effective June 1, 2025, reimbursed at $331 per day using HCPCS code T2033 with modifier U1. Only Federally Qualified Health Centers (Type 313) can currently provide this service with specific eligibility and documentation requirements.
Action Required
By August 26, 2025: Eligible FQHC providers must enroll as Provider Type 313 with New Mexico Medicaid and attest to NIMRC Standards compliance. Update billing system to use HCPCS code T2033 with modifier U1 and revenue code 0969 at $331 per diem rate. Ensure diagnosis codes Z59.00, Z59.01, or Z59.02 are in first 5 positions on claims. Retain clinical assessments for stays exceeding 61 days. Providers can submit retroactive claims back to June 1, 2025 within 90 days of this supplement date without timely filing denials.