MedicaidBilling CodesMedium impact
Supplement 23-06: Medicaid Billing for Human Donor Milk for Medicaid Eligible Recipients in Inpatient Hospital
New Mexico Medicaid·NM · Pediatrics, OB-GYN·Claims & Billing
Effective date
Jul 1, 2022
We identified it
Jun 21, 2026
Summary
New Mexico Medicaid now allows separate billing for pasteurized human donor milk (PHDM) for high-risk infants up to 12 months in inpatient settings, using revenue code 0220 and procedure code T2101. This is billed as outpatient services in addition to the regular inpatient DRG payment.
Action Required
For New Mexico hospital providers: Update billing systems to bill PHDM separately using revenue code 0220 and procedure code T2101 on UB-04 claims as outpatient services. Ensure clinical documentation meets eligibility requirements (infant under 12 months, birth weight under 2500g, qualifying medical conditions). Providers may submit retroactive claims for PHDM services provided from July 1, 2022 to present within 90 days of August 9, 2023 to avoid timely filing denials.