The New Mexico Health Care Authority has moved the Medicaid enrollment deadline for attending, referring, ordering, and prescribing providers to Oct 01, 2026.

This gives providers and pharmacists more time to complete their enrollment and avoid payment issues on future Medicaid claims.

Why This Update Matters

Beginning with dates of service on or after Oct 01, 2026, managed care organizations must deny claims when the attending, referring, ordering, or prescribing provider is not enrolled with New Mexico Medicaid.

This is part of a federal requirement that applies to care providers and pharmacists who deliver, order, refer, or prescribe services for Medicaid members.

What Providers Should Do

Providers should complete their enrollment through yes.nm.gov as early as possible. Since application processing can take time, submitting before the deadline can help reduce the risk of delayed payments or denied Medicaid claims.

Who Needs To Enroll

This requirement applies to providers and pharmacists across several care settings, including:

• Individual practices
• Group practices
• Hospitals and healthcare facilities
• Behavioral health agencies
• Indian Health Service programs

Claim Details To Include

To support accurate claim processing, providers should include the following information on applicable claims:

• National Provider Identifier
• Tax Identification Number
• Payer ID 87748
• Payer ID 87726 for electronic visit verification claims

Why Enrollment Is Required

Medicaid enrollment allows the state to confirm provider credentials, maintain accurate provider records, and ensure payment is issued only for services ordered, referred, prescribed, or delivered by qualified enrolled providers.

Need Help?

Providers can review enrollment information from the New Mexico Health Care Authority or contact HCA Provider Enrollment at 800-299-7304. Questions can also be sent to nm.providers@hca.nm.gov.