New Mexico Medicaid Portal



New Mexico Medicaid E-NewsNew Mexico Medicaid E-NewsFebruary 2, 2024Featured Updates and Notifications:Adjustment Submission Reminders - New1Q24 ASP Rate Update - NewHB2 Procedure Code Rate Update FY 2024 DRG Grouper 41 Implemented January 2024 Gross Receipts Tax Update 4Q ASP Rate Update HB2 Urban Hospital DRG Rate Update Fourth Quarter 2023 HCPCS Discontinued Codes Update Monthly IHS Open ForumNew Mexico Medicaid Provider Resource ListAdjustment Submission RemindersWhen submitting adjustments for paper, electronically (EDI), or via the web portal, please review these guidelines:Adjustments should only be submitted within the timely filing period, 90 days after the original claim payment date or 90 days from the date of the EOB.Paper adjustments submitted outside of the timely filing period will be returned to the provider.Web portal adjustments submitted outside of the timely filing period could deny and recoup the original payment.A corrected claim form and all required documents paper must be enclosed along with the adjustment request form for review. Only paid claims should be adjusted. Denied claims should be resubmitted.Voids are not subject to timely filing. January 20241Q24 ASP Rate UpdateThe 1st Quarter ASP rate updates, effective 1/1/2024, have been implemented as of 1/25/2024. Claims submitted with any of the updated codes and with effective dates on or after 1/1/2024 will be adjusted.January 2024HB2 Procedure Code Rate UpdateRate updates to procedure codes following HB2 have been implemented as of 12/14/2023. Claims submitted with any of the updated codes and with dates of service on or after 7/1/2023 will be mass adjusted.December 2023FY 2024 DRG Grouper 41 ImplementedDRG Version 41 Grouper has been loaded as of 12/11/2023. Inpatient DRG claims with discharge dates on or after 10/1/2023 were mass adjusted as of 1/8/2024. The list of DRGs can be found here: . December 2023January 2024 Gross Receipts Tax UpdateThe Gross Receipts Tax rates for the counties and cities listed below have been updated, effective January 1, 2024. The tax rate schedule is available on the NM Taxation & Revenue website: . Chaves County:Roswell7.8958%Guadalupe County:Santa Rosa 8.3750%Vaughn8.4875%Remainder of County6.3125%Otero County:Alamogordo8.1875%Cloudcroft7.8125%Tularosa7.6875%Remainder of County 6.2500%Sierra County:Williamsburg8.3750%December 20234th Quarter ASP Rate UpdateThe 4th Quarter ASP rate updates, effective 10/1/2023, have been implemented as of 12/15/2023. Claims submitted with any of the updated codes and with effective dates on or after 10/1/2023 will be adjusted.December 2023HB2 Urban Hospital DRG Rate UpdateThe institutional DRG rate for Urban Hospitals has been increased by 6% as of 11/15/2023. Claims submitted with effective dates on or after 7/1/2023 will be mass adjusted.November 2023 Fourth Quarter 2023 HCPCS Discontinued Codes UpdateThe 4th Quarter HCPCS Discontinued Code Update has been completed as of 11/2/2023. Claims submitted with these codes and with effective dates on or after 10/1/2023 will be mass adjusted. November 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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