MedicaidBilling CodesMedium impact
Supplement 24-04: Clarification on Billing for Nursing Facility Short-Term Stays
New Mexico Medicaid·NM · Geriatrics·Claims & Billing
Effective date
Apr 1, 2024
We identified it
Jun 21, 2026
Summary
New Mexico Medicaid clarifies that nursing facilities should use revenue code 0190 when billing for short-term stays under 90 days for Medicaid members covered by MCOs. These stays don't require Nursing Facility Level of Care determination and are reimbursed at contracted Low NF rates under the member's physical health benefit.
Action Required
By June 1, 2024: Nursing facilities must ensure their billing systems use revenue code 0190 for Medicaid short-term stays under 90 days when members are covered by MCOs. Verify that internal billing and MDS systems correctly reflect these stays as 'Medicaid' (not 'Medicaid Pending') to ensure proper HCQS reimbursement. MCOs must update authorization and claims processing systems within 60 days.