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MedicaidCoverageMedium impact

Supplement 23-05: Implementation of High-Fidelity Wraparound Program See Updated Supplement 24-02

New Mexico Medicaid·NM · Psychiatry, Pediatrics, Family Medicine·Medical Policy
Effective date
Jul 1, 2023
We identified it
Jun 21, 2026
Days to comply

Summary

New Mexico Medicaid is implementing High-Fidelity Wraparound (HFW) services for children with severe emotional disturbances, using billing code G9003. This service is no longer restricted to Health Homes and can be provided by approved providers who meet specific staffing and certification requirements.

Action Required

Action needed
Immediately: Providers interested in offering HFW services must complete the HFW Provider Application at centerofinnovationnm.org and obtain approval from the HFW Steering Committee. Ensure CANS assessment is completed before billing G9003 (1 unit per month). Staff must meet specific certification requirements including Wraparound certification from NMCBBHP within 6-12 months. FQHCs should use CMS 1500 claim form with encounter rate for reimbursement.

Affected Billing Codes

G9003