MedicaidCoverageMedium impact
Supplement 24-02: Implementation of High-Fidelity Wraparound Program Revised Replaces Supplement 23-05
New Mexico Medicaid·NM · Psychiatry, Pediatrics·Medical Policy
Effective date
Jul 1, 2023
We identified it
Jun 21, 2026
Summary
New Mexico Medicaid has revised billing guidance for High-Fidelity Wraparound (HFW) services for children with severe emotional disturbance, expanding eligible providers beyond Health Homes to any HFW Steering Committee-approved provider. The policy establishes specific staffing requirements and sets the reimbursement rate at $1,995.41 for CPT code G9003.
Action Required
Immediately: Providers interested in HFW services must complete the HFW Provider Application at https://centerofinnovationnm.org/nm-wraparound/wrap-provider-application/ and obtain approval letter before billing. Ensure staff meet specific certification requirements including Wraparound Facilitator certification from NMCBBHP within 6-12 months. Bill CPT code G9003 at $1,995.41 rate for eligible recipients meeting all four eligibility criteria. Coordinate with MCO care coordinators and provide HFW action plans after each team meeting.