New Mexico Medicaid: State enrollment is required for claim payment
Avoid claim denials by registering with yes.nm.gov today
Effective for dates of service July 1, 2026, and beyond, New Mexico Medicaid will deny claims when the attending, referring, ordering and prescribing providers are not enrolled with Medicaid. This requirement is federally mandated for all U.S. care providers and pharmacists who render services to Medicaid members in each state.
For enrollment instructions, visit the New Mexico Health Care Authority (HCA) Providers Overview: Ordering, Referring, Prescribing. Allow ample time for HCA to process the applications before July 1, 2026, to help ensure your Medicaid claims are not denied.
Who must enroll?
This requirement applies to all providers and pharmacists, including those in:
- Individual practices
- Group practices, hospital systems and facilities
- Behavioral health agencies
- Indian Health Service programs
Include the following on your claim:
- National Provider Identifier (NPI) number
- Tax identification number (TIN)
- Payer ID 87748 (Use 87726 for electronic visit verification claims)
Why is registration needed?
Medicaid enrollment helps the state verify credentials, keep provider information current and ensure payment is made only for services ordered or delivered by qualified, enrolled providers.
Questions?
Review the HCA list of frequently asked questions or contact HCA Provider Enrollment at 800-299-7304 or nm.providers@hca.nm.gov.
PCA-1-26-00658-C&S-NN_05152026
