New Hampshire Medicaid — New Hampshire Medicaid (Medicaid Care Management)
| Program name | New Hampshire Medicaid (Medicaid Care Management) |
|---|---|
| Provider portal | https://www.dhhs.nh.gov |
| FFS claims payer ID | No single canonical ID — routing is fiscal-intermediary-specific. Verify per clearinghouse. |
| Medicaid timely filing | 180 days from date of service |
The federal ceiling for Medicaid timely filing is 12 months under 42 CFR §447.45; most states set a shorter window. Always verify the current policy on the New Hampshire Medicaid provider portal before filing a late-billing appeal.
BCBS licensee in New Hampshire
The Blue Cross Blue Shield Association licensee in New Hampshire is Anthem Blue Cross and Blue Shield New Hampshire (Elevance Health). See the Anthem (Elevance Health) payer guide for payer ID, timely filing, prior auth, and appeal procedures.
Top commercial payers in New Hampshire
The dominant commercial insurers operating in New Hampshire, in approximate order of lives covered. Click through for per-payer claims payer IDs, timely filing windows, prior-authorization rules, and appeal procedures.
Medicaid MCOs in New Hampshire
New Hampshire Medicaid (Medicaid Care Management) contracts with the following managed-care organizations to administer Medicaid benefits in New Hampshire. MCO contracts dictate claims routing, prior-auth workflows, and appeal deadlines — route each claim by the member's MCO assignment, not the state FFS payer ID.
Medicare contractor and active LCDs in New Hampshire
Wellpoint Federal is the Medicare A/B MAC for New Hampshire: Part A and Part B fee-for-service claims from New Hampshire go to it, and its Local Coverage Determinations decide local medical necessity. Durable medical equipment and supply claims go to Noridian Healthcare Solutions, LLC as the DME MAC. Home health and hospice claims are processed by Wellpoint Federal. In the current Medicare Coverage Database export, 147 active LCDs from these contractors apply to New Hampshire claims.
- Wellpoint Federal
A/B MAC (Part A and Part B claims); Home health and hospice MAC
- Noridian Healthcare Solutions, LLC
DME MAC (durable medical equipment and supplies)
Selected active Wellpoint Federal policies for New Hampshire
A selection, not the full list: policies with measured search demand come first, then those on topics that more contractors publish LCDs for.
- L33627 Non-Invasive Vascular Studies
- L33394 Drugs and Biologicals, Coverage of, for Label and Off-Label Uses
- L35936 Facet Joint Interventions for Pain Management
- L39036 Epidural Steroid Injections for Pain Management
- L35000 Molecular Pathology Procedures
- L33577 Transthoracic Echocardiography (TTE)
- L33631 Outpatient Physical and Occupational Therapy Services
- L33632 Psychiatry and Psychology Services
- L33557 Cardiac Catheterization and Coronary Angiography
- L33569 Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF)
- L33636 Routine Foot Care and Debridement of Nails
- L33622 Pain Management - Injection of tendon sheaths, ligaments, bursa, and ganglion cysts
Equipment, home health and hospice policies that apply in New Hampshire
- L33822 Glucose Monitors
- L33789 Power Mobility Devices
- L33318 Knee Orthoses
- L33686 Ankle-Foot/Knee-Ankle-Foot Orthosis
- L33718 Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea
- L33792 Wheelchair Options/Accessories
- L33797 Oxygen and Oxygen Equipment
- L33393 Hospice - Determining Terminal Status
Steps to confirm which LCD governs a claim · Every active LCD by contractor
State-specific regulations affecting New Hampshire billing
- RSA §420-J:8-a (NH Surprise Bill Consumer Protections, as amended 2018)
- RSA §420-J:8 (prompt pay — 15 days electronic clean claim)
- RSA §151-E (hospital financial assistance)
Provider licensing & enrollment in New Hampshire
Providers enroll via NH Medicaid Provider Enrollment (Conduent MMIS). MCM MCOs credential separately.
Major health systems headquartered in New Hampshire
| Health system | Headquarters |
|---|---|
| Dartmouth Health (Dartmouth-Hitchcock) | Lebanon, NH |
| Catholic Medical Center | Manchester, NH |
| Elliot Health System (SolutionHealth) | Manchester, NH |
| Wentworth-Douglass Hospital (Mass General Brigham) | Dover, NH |
| Concord Hospital | Concord, NH |
Frequently asked questions — New Hampshire billing
What is the New Hampshire Medicaid program called?
New Hampshire's Medicaid program is known as New Hampshire Medicaid (Medicaid Care Management). Providers enroll and manage claims through the provider portal at https://www.dhhs.nh.gov.
What is the New Hampshire Medicaid timely filing limit?
New Hampshire Medicaid (Medicaid Care Management) requires initial claims to be filed within 180 days from the date of service. The federal ceiling is 12 months under 42 CFR §447.45; New Hampshire's 180-day window is set by the state provider manual. Late-billing exceptions may be allowed with good-cause documentation — verify on the state portal before filing an appeal.
Does New Hampshire Medicaid publish a single claims payer ID?
No single canonical claims payer ID is published for New Hampshire Medicaid (Medicaid Care Management). Claims route through the state's fiscal intermediary; look up the correct submitter ID in your clearinghouse directory (Availity, Change Healthcare/Optum, Waystar) and route managed-care claims by the member's MCO assignment.
Who are the largest commercial insurers in New Hampshire?
The dominant commercial payers in New Hampshire include Anthem (Elevance Health), Harvard Pilgrim, UnitedHealthcare, Aetna, Cigna, along with the BCBS licensee Anthem Blue Cross and Blue Shield New Hampshire (Elevance Health). Each payer's claims routing, timely filing, and prior-auth rules differ — see the per-payer guides linked above.
What Medicaid managed-care organizations operate in New Hampshire?
New Hampshire Medicaid (Medicaid Care Management) contracts with 3 Medicaid MCOs tracked in the QuickIntell registry, including Anthem (Elevance Health), WellSense, Amerigroup. MCO contracts determine claims routing and appeal deadlines — route each claim by the member's MCO assignment, not by the FFS payer ID.
What state-specific billing regulations apply in New Hampshire?
New Hampshire has 3 tracked state-level statutes that affect medical billing and RCM: RSA §420-J:8-a (NH Surprise Bill Consumer Protections, as amended 2018); RSA §420-J:8 (prompt pay — 15 days electronic clean claim); RSA §151-E (hospital financial assistance). These sit on top of federal protections such as the No Surprises Act, HIPAA, and 42 CFR §447.45.
Run cleaner claims in New Hampshire with QuickIntell
QuickRCM, QuickAuth, and QuickERA are tuned to New Hampshire Medicaid (Medicaid Care Management) and the commercial payers on this page — eligibility, prior auth, claim scrubbing, and ERA posting all run on real payer rules, not generic adapters.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. State Medicaid policies, MCO contracts, and payer rules change without notice — always verify against the current provider manual from New Hampshire Medicaid and the member ID card before submission.