MedicaidDocumentationMedium impact
Reinforce Prenatal and Postpartum Care to Support Whole Health
BCBS New Mexico·NM · OB-GYN, Family Medicine, Internal Medicine·General
Effective date
Apr 16, 2026
We identified it
Jun 18, 2026
Summary
Blue Cross Blue Shield of New Mexico is reinforcing HEDIS quality measures for prenatal and postpartum care, emphasizing depression screening and follow-up requirements. The policy extends Medicaid postpartum coverage from 60 days to 12 months for Turquoise Care members and provides specific guidelines for qualifying visits and depression screening protocols.
Action Required
Immediately: Providers must ensure prenatal visits are scheduled within 14 weeks of gestation and postpartum visits occur between 7-84 days after delivery. Implement age-appropriate depression screening (PHQ-9, PHQ-2, or Edinburgh Postnatal Depression Scale) during pregnancy and postpartum visits. For positive screenings, follow up within 30 days with evaluation, referral, or treatment. Update EMR templates to include depression screening documentation. Note that ultrasound/lab results alone don't count as prenatal visits and must be combined with office visits.