New Mexico Medicaid — New Mexico Medicaid (Turquoise Care — formerly Centennial Care)
| Program name | New Mexico Medicaid (Turquoise Care — formerly Centennial Care) |
|---|---|
| Provider portal | https://www.hca.nm.gov |
| FFS claims payer ID | No single canonical ID — routing is fiscal-intermediary-specific. Verify per clearinghouse. |
| Medicaid timely filing | 90 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 Mexico Medicaid provider portal before filing a late-billing appeal.
BCBS licensee in New Mexico
The Blue Cross Blue Shield Association licensee in New Mexico is Blue Cross and Blue Shield of New Mexico (HCSC). This licensee is not yet in the QuickIntell payer registry. See the full payer directory or the BCBSA national site for a provider-portal link.
Top commercial payers in New Mexico
The dominant commercial insurers operating in New Mexico, 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 Mexico
New Mexico Medicaid (Turquoise Care — formerly Centennial Care) contracts with the following managed-care organizations to administer Medicaid benefits in New Mexico. 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.
State-specific regulations affecting New Mexico billing
- NMSA §59A-57-1 to §59A-57-10 (NM Surprise Billing Protection Act, 2019)
- NMSA §59A-16-21.1 (prompt pay — 30 days electronic clean claim)
- NMSA §24-1-5.1 (hospital financial assistance / uncompensated care)
Provider licensing & enrollment in New Mexico
Providers enroll via NM Medicaid Web Portal (Conduent). Turquoise Care MCOs credential via CAQH ProView.
Major health systems headquartered in New Mexico
| Health system | Headquarters |
|---|---|
| Presbyterian Healthcare Services | Albuquerque, NM |
| University of New Mexico Hospital (UNMH) | Albuquerque, NM |
| Christus St. Vincent Regional Medical Center | Santa Fe, NM |
| Lovelace Health System (Ardent) | Albuquerque, NM |
| San Juan Regional Medical Center | Farmington, NM |
Frequently asked questions — New Mexico billing
What is the New Mexico Medicaid program called?
New Mexico's Medicaid program is known as New Mexico Medicaid (Turquoise Care — formerly Centennial Care). Providers enroll and manage claims through the provider portal at https://www.hca.nm.gov.
What is the New Mexico Medicaid timely filing limit?
New Mexico Medicaid (Turquoise Care — formerly Centennial Care) requires initial claims to be filed within 90 days from the date of service. The federal ceiling is 12 months under 42 CFR §447.45; New Mexico's 90-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 Mexico Medicaid publish a single claims payer ID?
No single canonical claims payer ID is published for New Mexico Medicaid (Turquoise Care — formerly Centennial Care). 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 Mexico?
The dominant commercial payers in New Mexico include UnitedHealthcare, Aetna, Cigna, Humana, Molina Healthcare, along with the BCBS licensee Blue Cross and Blue Shield of New Mexico (HCSC). 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 Mexico?
New Mexico Medicaid (Turquoise Care — formerly Centennial Care) contracts with 3 Medicaid MCOs tracked in the QuickIntell registry, including Molina Healthcare, UnitedHealthcare, Centene. 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 Mexico?
New Mexico has 3 tracked state-level statutes that affect medical billing and RCM: NMSA §59A-57-1 to §59A-57-10 (NM Surprise Billing Protection Act, 2019); NMSA §59A-16-21.1 (prompt pay — 30 days electronic clean claim); NMSA §24-1-5.1 (hospital financial assistance / uncompensated care). These sit on top of federal protections such as the No Surprises Act, HIPAA, and 42 CFR §447.45.
Run cleaner claims in New Mexico with QuickIntell
QuickRCM, QuickAuth, and QuickERA are tuned to New Mexico Medicaid (Turquoise Care — formerly Centennial Care) 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 Mexico Medicaid and the member ID card before submission.