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MedicaidReimbursementMedium impact

Supplement 24-22: Implementation of Certified Community Behavioral Health Clinics See Updated Supplement 25-06

New Mexico Medicaid·NM · Psychiatry, Family Medicine, Pediatrics +1 more·Specialty Services
Effective date
Jan 1, 2025
We identified it
Jun 21, 2026
Days to comply

Summary

New Mexico is implementing a Certified Community Behavioral Health Clinic (CCBHC) demonstration program starting January 1, 2025, with a new prospective payment system (PPS-1) that pays a fixed daily rate per beneficiary regardless of the number of qualifying services provided. Seven provisionally certified CCBHCs will begin providing comprehensive behavioral health services under this new reimbursement model.

Action Required

Action needed
By January 1, 2025: Behavioral health practices in New Mexico should review CCBHC qualification criteria and consider applying for certification if they meet requirements. Practices working with CCBHCs must understand the new PPS-1 daily rate billing model and update contracts accordingly. Check NMrecovery.org/CCBHC for qualifying service code lists and certification information.