MedicaidBilling CodesMedium impact
Supplement 21-03: Home & Community Based Services – Supports Waiver Fee Schedule
New Mexico Medicaid·NM·Claims & Billing
Effective date
May 1, 2021
We identified it
Jun 21, 2026
Summary
New Mexico has updated the Supports Waiver fee schedule to separate billing codes for Participant Directed vs Agency Based service delivery models. Several Agency Based codes have been updated for services like Assistive Technology, Community Support Coordinator, and Transportation, plus a new 'UA' modifier was added for Community Support Coordinator services.
Action Required
Immediately: Billing teams serving New Mexico Supports Waiver patients must update billing systems to use correct codes based on service delivery model. For Agency Based services, use updated codes: T2028 for Assistive Technology (instead of T1999), T2021 for Group Customized Community Support (instead of S5100), A0170 for Commercial Transportation (instead of T2003), and A0160 for Mileage (instead of T2049). Add new 'UA' modifier to all Community Support Coordinator billing codes S5190 and T2025. Update fee schedules and ensure staff can distinguish between Participant Directed and Agency Based models.