New Mexico Medicaid Portal



New Mexico Medicaid E-NewsNew Mexico Medicaid E-NewsOctober 31, 2023Featured Updates and Notifications:HB2 Hospital DRG and Outpatient Rate UpdateThird Quarter 2023 HCPCS New Code UpdateFFY 2024 ICD10 Code UpdateHB2 Hospital Rate Increases - SeptemberFinal HB2 ICF Facility Rate UpdateFinal HB2 Nursing Facility Rate UpdateThird Quarter 2023 Existing HCPCS Annual UpdateFQHC House Bill 2 Rate Increase EDI Medicare Replacement Claim Billing Notice – UB ClaimsMonthly IHS Open ForumNew Mexico Medicaid Provider Resource ListHB2 Hospital DRG and Outpatient Rate UpdateThe institutional rates for the following hospital types have been increased as of 10/30/2023. Claims submitted with effective dates on or after 7/1/2023 will be mass adjusted.Outpatient Percentage for Urban Hospitals 6%Outpatient Percentage for Underserved Hospitals 20%DRG for Rural Hospitals 12%Outpatient Percentage for Urban Hospitals 6%DRG for UNM Hospitals 4%DRG for Underserved Hospitals 20%Outpatient Percentage for Rural Hospitals 12% October 2023Third Quarter 2023 HCPCS New Code UpdateThe 3rd Quarter New HCPCS Code Annual Update has been completed as of 10/13/2023. Claims submitted with these codes and with effective dates on or after 7/1/2023 will be mass adjusted. October 2023 FFY 2024 ICD10 Code UpdateNew ICD10 – Clinical Modification Codes for FFY 2024 have been added as of 10/11/2023. Claims submitted with these codes on or after 10/1/2023 will be mass adjusted.October 2023 HB2 Hospital Rate Increases - SeptemberThe institutional rates for the following hospital types have been increased as of 9/15/2023. Claims submitted with effective dates on or after 7/1/2023 will be mass adjusted.In-State Rural Hospitals 12%Urban Hospitals 6%Underserved Hospitals 20%UNM Hospitals 4%September 2023Final HB2 ICF Facility Rebase Rate UpdateThe HB2 rates for ICF Facilities (Medicaid Provider types 214 and 215) have been updated as of 9/7/23. Claims submitted with effective dates on or after 9/1/2023 will be mass adjusted.September 2023 Final HB2 Nursing Facility Rate UpdateThe HB2 rates for Nursing Facilities (Medicaid Provider types 211 and 212) have been updated as of 9/11/2023. Claims submitted with effective dates on or after 7/1/2023 will be mass adjusted.September 2023Third Quarter 2023 HCPCS Annual UpdateThe 3rd Quarter HCPCS Existing Code Annual update has been completed as of 9/11/2023. Claims submitted with the updated codes and with effective dates on or after 7/1/2023 will be adjusted.September 2023FQHC House Bill 2 Rate IncreaseThe institutional rates for FQHC (excluding tribal) providers were increased by 6% per House Bill 2, effective July 1, 2023. Claims submitted with effective dates on or after July 1, 2023 will be mass adjusted.August 2023EDI Medicare Replacement Claim Billing Notice – UB ClaimsFor providers who bill Medicaid UB-04 claims secondary to a Medicare Replacement payor through EDI and the claims deny for Medicare required, the following correction is needed:The indicator code in Loop 2320, Segment SBR09 (Other Subscriber Indicator field) should be 16 for Medicare Replacement plan claims. August 2023Monthly IHS Open ForumThe monthly IHS Open Forum is available for all IHS and Tribal 638 staff. The forum is on the second Wednesday of every month from 2:00 to 3:00 pm Mountain time. Microsoft TEAMS meeting - Click here to join the meeting Join by phone (audio) – 1-585-420-6781, conference ID 66481421#New Mexico Medicaid Provider Resource ListNew Mexico Medicaid Portal - Claim Inquiries, Eligibility verification, Electronic claim submission, Provider manuals, E-NewsMedical Assistance Division Program Rules - NMAC for programs administered by the Medical Assistance DivisionNM Human Services Department - Supplements, Memos, Provider Billing Packets and PolicyConsolidated Call Center – (800) 299 – 7304Provider Inquiries email: NMProviders@hsd.Member Inquiries email: NMMembers@hsd.HIPAA Inquiries link: HIPPAA.DeskNM@hsd. EDI or Portal Password ResetsDisclosure – The objective of the E-News, training, and webinars is to inform and educate. Articles reflect information at the current time and may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations, and other interpretive materials for a full and accurate statement of their content. E-News is published monthly and is available on the NM Medicaid Web Portal. ................
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