New Mexico Medicaid: Requirement to enroll with state delayed to October
Avoid claim denials by registering with yes.nm.gov today
New Mexico Health Care Authority (HCA) has extended the deadline for attending, referring, ordering and prescribing providers to enroll with Medicaid to Oct. 1, 2026.
HCA mandates that MCOs deny claims with Oct. 1, 2026, date of service and beyond 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 Oct. 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 information from HCA on enrolling as Medicaid providers, contact HCA Provider Enrollment at 800-299-7304 or visit nm.providers@hca.nm.gov.
Note: The original version of this article, “New Mexico Medicaid: State enrollment is required for claim payment,” with the state’s enrollment date of July 1, 2026, appeared in the June 2026 issue of Network News.
PCA-1-26-01051-C&S-NN_06182026
