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New Mexico Medicaid reimbursement rates

31,727 current fee-for-service and managed-care rates from New Mexico Medicaid, across 140 services and 9 programs, normalized by code, provider level and unit. Each links to one of 49 official source documents.

Last retrieved 2026-10-05. History back to 2005-01-01.

Current rates
31,727
Services
140
Programs
9
Lines with a plan rule
22of 22 service lines

By industry

New Mexico rates by service

The median current rate for each service, like-for-like by unit. Follow a service to compare it with every other state.

ServiceLineMedian rateUnitPer hourVariants
ABA assessment by a behavior analystABA / autism services$130.9415 min$523.763
ABA assessment support by a technicianABA / autism services$65.4715 min$261.883
ABA assessment with 2+ technicians (severe behavior)ABA / autism services$130.9415 min$523.763
ABA parent and caregiver trainingABA / autism services$35.7915 min$143.163
ABA therapy with 2+ technicians (severe behavior)ABA / autism services$119.0515 min$476.203
ABA therapy with plan changes by an analystABA / autism services$142.84hour$150.809
Group ABA parent training (several families)ABA / autism services$71.4315 min$285.723
Group ABA therapy led by a technicianABA / autism services$18.5915 min$74.3610
Group ABA therapy led by an analystABA / autism services$15.8815 min$63.526
One-on-one ABA therapy by a technicianABA / autism services$32.3115 min$129.245
Assertive Community Treatment (ACT) teamBehavioral health$79.5015 min$318.004
Behavioral health day treatmentBehavioral health$27.78hour$27.781
Behavioral health nursing (RN/LPN)Behavioral health$47.5815 min$103.842
Behavioral health prevention educationBehavioral health$57.1830 min$114.352
Behavioral health services (fee schedule)Behavioral health$304.72——1
Community-based wraparound servicesBehavioral health$2,336.23month—1
Comprehensive community support servicesBehavioral health$31.0715 min$124.266
Crisis intervention (behavioral health)Behavioral health$54.7015 min$218.788
Functional family therapy (FFT)Behavioral health$77.3915 min$309.568
Intensive outpatient program (behavioral health)Behavioral health$276.40day—4
Medication administration (behavioral health)Behavioral health$261.88Unit = 1 service$190.482
Mental health assessment (non-physician)Behavioral health$206.33Unit = 1 Service$206.3311
Mental health community residence (rehab services)Behavioral health$290.49day—1
Mental health service plan developmentBehavioral health$206.33bill 1 unit for a session of 30 to 89 minutes—7
Mobile and telephone crisis responseBehavioral health$86.76encounter$308.249
Multisystemic therapy for youthBehavioral health$69.2015 min$276.808
Opioid treatment: methadone administrationBehavioral health$21.11day—1
Outpatient psychotherapy and diagnostic evaluationBehavioral health$142.92—$242.3475
Peer support (behavioral health)Behavioral health$18.2515 min$72.982
Psychiatric partial hospitalizationBehavioral health$793.57day—1
Psychiatric residential treatment (daily)Behavioral health$677.80day—3
Psychological and developmental testingBehavioral health$58.49—$120.5513
Psychosocial rehabilitationBehavioral health$14.7315 min$58.922
Screening, brief intervention and referral (SBIRT)Behavioral health$39.36Unit = 1$243.144
Skills training and developmentBehavioral health$14.4815 min$57.921
SUD residential treatment (per day)Behavioral health$349.76day—3
Therapeutic behavioral servicesBehavioral health$31.0815 min$124.323
Therapeutic foster care (child)Behavioral health$428.04day—2
FQHC/RHC payment method parameterClinics (FQHC/RHC)$6.00percent—1
Dental servicesDental$134.57——249
Durable medical equipmentEquipment & supplies$74.43—$101.881963
Enteral and parenteral nutritionEquipment & supplies$11.35day—67
Medical suppliesEquipment & supplies$15.12——581
Orthotics and prostheticsEquipment & supplies$578.14—$113.50878
Adult day servicesOther home & community services$2.9615 min$11.843
Assisted living / alternative living servicesOther home & community services$129.83day—1
Case management / support coordinationOther home & community services$141.3615 min$106.086
Emergency response system installationOther home & community services$1.06——1
Emergency response system monitoringOther home & community services$5.48day—1
Employment supports (HCBS, non-IDD)Other home & community services$321.79day—1
Financial management services (self-direction)Other home & community services$120.00per ISP year for each service as utilized—1
HCBS waiver service (other)Other home & community services$536.88Each—3
Home-delivered mealsOther home & community services$59.65meal—6
Nursing respite (RN or LPN)Other home & community services$15.7015 min$62.804
Respite care (daily)Other home & community services$283.00day—2
Respite care (hourly)Other home & community services$7.9415 min$31.769
Self-direction coaching / supports brokerOther home & community services$231.13month—3
Service planning meetingOther home & community services$395.00Each—2
Home health occupational therapyHome health$49.6615 min$198.643
Home health physical therapyHome health$49.6615 min$198.643
Home health speech therapyHome health$49.6615 min$198.643
Hospice continuous home care (hourly)Hospice$1,573.42——61
Hospice end-of-life visit add-on (per hour)Hospice$64.95——116
Hospice general inpatient care (daily)Hospice$1,138.89——116
Hospice inpatient respite (daily)Hospice$536.06——116
Hospice routine home care (daily)Hospice$194.97——122
IHS / tribal hospital stay (all-inclusive daily rate)Hospital inpatient$5,707.00day—1
Inpatient capital payment (building and equipment)Hospital inpatient$322.70——34
Inpatient DRG pricing input (outlier, cost ratio, stay)Hospital inpatient$3,597.99——11
Inpatient DRG relative weightHospital inpatient$1.91——770
Inpatient hospital stay (DRG base rate)Hospital inpatient$5,618.03——35
IHS / tribal outpatient visit (all-inclusive rate)Hospital outpatient$826.00visit—1
Outpatient hospital payment methodHospital outpatient$97.00percent—1
Outpatient hospital services (fee schedule)Hospital outpatient$328.61—$116.009613
Surgery center facility fee (per procedure)Hospital outpatient$734.64——3317
Additional residential staffingIDD services$65.22day—1
Behavior support services (disability waiver)IDD services$31.0815 min$124.329
Community integration / community access (IDD)IDD services$6.7515 min$27.0013
Consultative clinical assessment (IDD)IDD services$32.3615 min$129.442
Crisis services for people with I/DD (monthly tier)IDD services$250.24day$40.882
ICF/IID stay (daily rate)IDD services$456.26——126
In-home and community living supports (IDD)IDD services$17.5315 min$34.924
Job development and self-employment outcome paymentsIDD services$105.0015 min$48.283
Residential habilitation / group home supportsIDD services$425.32day—6
Shared living / host home / family modelIDD services$191.71day—1
Supported employment (job coaching)IDD services$6.9315 min$27.729
Supported employment follow-alongIDD services$1,363.11month—1
Clinical lab testsLab & pathology$32.36——1902
Nursing home daily add-on (ventilator, trach, insurance)Nursing facility$19.67day—2
Nursing home payment method parameterNursing facility$5.85percent—2
Nursing home stay (daily rate)Nursing facility$428.61——136
Nursing home ventilator care (daily rate)Nursing facility$305.66day—1
Birth center delivery facility rateOther$3,550.00——1
Birth center observation services rateOther$70.00——1
Birth center transfer feeOther$819.56——1
Directed payment program total (CMS-approved amount)Other$34,000,000.00rating period—7
Directed payment uniform increase (required MCO uplift)Other$33.00percent—14
Directed payment: plan payment level (% of benchmark)Other$49.30percent—31
Directed payment: required minimum or maximum levelOther$95.00percent—1
Doula support during labor and deliveryOther$1,500.00Max of 1 unit - billed after delivery—1
Doula visit (prenatal or postpartum)Other$25.0015 min$100.002
Early intervention services for infants and toddlersOther$38.50—$141.508
Lactation consultationOther$69.21——5
Maternal and infant health program visit (assessment, professional or home visit)Other$276.04——24
Medical respite (recuperative care) for people experiencing homelessness, dailyOther$331.00day—1
School-based Medicaid service (billed by a school district)Other$30.071 evaluation$40.30181
Home health aide or nurse aide care (hourly)Personal care & attendant$35.52hour$35.524
Homemaker / housekeeping helpPersonal care & attendant$11.64hour$11.642
Personal care / attendant care (hourly)Personal care & attendant$16.4015 min$25.728
Physician-administered drugs (J-codes)Pharmacy$12.26——1077
Waiver nursing (RN or LPN, by the 15 minutes)Private duty nursing$24.8315 min$99.3012
Anesthesia base units (per procedure)Physician & professional$5.00base unit—274
Anesthesia conversion factorPhysician & professional$18.43——1
Community health worker education and trainingPhysician & professional$19.7530 min$39.503
Physician and practitioner services (fee schedule)Physician & professional$687.93—$124.927598
Telehealth originating-site facility feePhysician & professional$30.43encounter—1
Imaging and radiologyRadiology$82.88——1719
Activity therapyTherapy (PT/OT/speech)$31.92Unit = 1 service$105.326
Cognitive rehabilitation therapyTherapy (PT/OT/speech)$26.3315 min$105.325
Nutrition counseling (dietitian)Therapy (PT/OT/speech)$51.1415 min$88.887
Occupational therapyTherapy (PT/OT/speech)$49.6615 min$198.6413
Occupational therapy evaluationTherapy (PT/OT/speech)$143.05——4
Orthotic and prosthetic fitting and trainingTherapy (PT/OT/speech)$66.1615 min$264.643
Other therapy servicesTherapy (PT/OT/speech)$78.9915 min$105.3218
Physical therapyTherapy (PT/OT/speech)$44.4215 min$177.6812
Physical therapy evaluationTherapy (PT/OT/speech)$141.72——4
Speech-generating device evaluationTherapy (PT/OT/speech)$174.91——1
Speech-generating device therapyTherapy (PT/OT/speech)$145.55——1
Speech-language evaluationTherapy (PT/OT/speech)$173.69——4
Speech-language therapyTherapy (PT/OT/speech)$49.66—$198.648
Swallowing and feeding evaluationTherapy (PT/OT/speech)$120.56——1
Swallowing and feeding therapyTherapy (PT/OT/speech)$119.72——1
Air ambulance transportTransportation$2,860.46one time—6
Ambulance mileageTransportation$13.41one time—9
Ground ambulance transportTransportation$278.26one time—18
Non-emergency medical transportation (NEMT)Transportation$0.71mile—12
Travel lodging for a medical appointment (per night)Transportation$52.58day—5
Waiver transportation (to community activities)Transportation$0.66mile$15.385
Eyeglasses and contact lensesVision & hearing$118.38——35
Hearing aids and hearing servicesVision & hearing$74.81——14

Most-compared billing codes in New Mexico

Where New Mexico ranks among states for codes published widely. Rank 1 = highest rate.

CodeServiceNew MexicoAll-state medianRank
10005Physician and practitioner services (fee schedule)$156.95$83.283 of 39
10006Physician and practitioner services (fee schedule)$70.73$44.974 of 39
10007Physician and practitioner services (fee schedule)$279.77$177.574 of 39
10008Physician and practitioner services (fee schedule)$146.75$83.284 of 39
10009Physician and practitioner services (fee schedule)$441.30$263.063 of 39
10010Physician and practitioner services (fee schedule)$255.16$137.614 of 39
10021Physician and practitioner services (fee schedule)$142.05$68.562 of 39
10030Physician and practitioner services (fee schedule)$863.35$326.392 of 39
10060Physician and practitioner services (fee schedule)$178.01$86.862 of 39
10061Physician and practitioner services (fee schedule)$303.77$150.173 of 39
10080Physician and practitioner services (fee schedule)$344.37$115.262 of 39
10081Physician and practitioner services (fee schedule)$478.98$187.272 of 39
10120Physician and practitioner services (fee schedule)$212.16$95.053 of 39
10121Physician and practitioner services (fee schedule)$373.01$160.553 of 39
10140Physician and practitioner services (fee schedule)$238.20$105.163 of 39
10160Physician and practitioner services (fee schedule)$182.10$81.683 of 39
10180Physician and practitioner services (fee schedule)$370.22$160.692 of 39
11000Physician and practitioner services (fee schedule)$82.74$36.552 of 39
11001Physician and practitioner services (fee schedule)$38.31$16.932 of 39
11004Physician and practitioner services (fee schedule)$826.80$437.212 of 39
11005Physician and practitioner services (fee schedule)$1,132.21$581.922 of 39
11006Physician and practitioner services (fee schedule)$1,021.61$542.162 of 39
11008Physician and practitioner services (fee schedule)$398.89$208.642 of 39
11010Physician and practitioner services (fee schedule)$627.92$275.933 of 39
11011Physician and practitioner services (fee schedule)$704.31$303.313 of 39
11012Physician and practitioner services (fee schedule)$919.86$414.553 of 39
11042Physician and practitioner services (fee schedule)$180.18$78.712 of 39
11043Physician and practitioner services (fee schedule)$329.12$164.233 of 39
11044Physician and practitioner services (fee schedule)$444.07$216.703 of 39
11055Physician and practitioner services (fee schedule)$97.41$30.692 of 39
11056Physician and practitioner services (fee schedule)$113.38$35.452 of 39
11057Physician and practitioner services (fee schedule)$124.44$41.792 of 39
11102Physician and practitioner services (fee schedule)$138.57$65.282 of 39
11103Physician and practitioner services (fee schedule)$69.58$32.912 of 39
11104Physician and practitioner services (fee schedule)$172.73$80.282 of 39
11105Physician and practitioner services (fee schedule)$82.64$40.623 of 39
11106Physician and practitioner services (fee schedule)$214.52$96.492 of 39
11107Physician and practitioner services (fee schedule)$98.79$47.423 of 39
11300Physician and practitioner services (fee schedule)$138.30$44.472 of 39
11301Physician and practitioner services (fee schedule)$168.14$60.302 of 39

Managed care in New Mexico

5 plans on record, 53 state-directed payment records.

Who sets the rate, line by line →

Recent rate changes and notices

NoticeStatusEffective
NM HCA register Volume 49 Register 26: Proposed Rules - 8.200.400 NMAC, GENERAL RECIPIENT RULES, GENERAL MEDICAID ELIGIBILITY 8.245.400 NMAC, MEDICAID ELIGIBILITY, SPECIFIED LOproposed2027-01-01
NM HCA register Volume 49 Register 28: Proposed Rule - 8.310.3 NMAC, HEALTH CARE PROFESSIONAL SERVICES, PROFESSIONAL PROVIDERS, SERVICES AND REIMBURSEMENTproposed2027-01-01
NM HCA register Volume 49 Register 30: Proposed Rule - 8.324.5 NMAC, VISION APPLIANCES, HEARING APPLIANCES, DURABLE MEDICAL EQUIPMENT, OXYGEN, MEDICAL SUPPLIES, PROSTHETICS ANproposed2027-01-01
NM HCA register Volume 49 Register 33: Proposed Rules - 8.308.9 NMAC, MANAGED CARE PROGRAM, BENEFIT PACKAGE 8.324.4 NMAC, ADJUNCT SERVICES, PHARMACY SERVICES, PRESCRIBING, ANDproposed2027-01-01
NM Program Rule Supplement 26-05effective2026-09-03
NM HCA register Volume 49 Register 14: Proposed Rules - 8.200.510 NMAC, GENERAL RECIPIENT POLICIES, RESOURCE STANDARDS 8.200.520 NMAC, GENERAL RECIPIENT RULES, INCOME STANDARDSproposed2026-09-01
NM HCA register Volume 49 Register 27: Final Rules - 8.281.510 NMAC, 8.313.3. NMAC, 8.326.2 NMAC 8.350.4 NMAC, 8.370.3 NMAC, 8.370.4 NMAC, 8.370.9 NMAC, 8.370.16 NMAC, 8.371enacted2026-09-01
NM HCA register Volume 49 Register 31: Final Rule - 8.324.7 NMAC, ADJUNCT SERVICES, TRANSPORTATION SERVICES AND LODGINGenacted2026-09-01
NM SPA 26-0008: To align with CMS and American Medical Association (AMA) changes to eliminate all global maternity codes (e.g., 59400, 5submitted2026-09-01
Notice of Opportunity to Comment #59: Mi Via Waiver amendment applicationproposed2026-08-18
NM SPA 26-0003: The NM HCA plans to implement a unified, single Preferred Drug List (PDL) for Medicaid and update reimbursement methodolapproved_cms2026-08-13
NM HCA register Volume 49 Register 8: Proposed Rules - 8.308.6 NMAC, MANAGED CARE ORGANIZATION (MCO) ENROLLMENT 8.308.7 NMAC, ENROLLMENT AND DISENROLLMENT 8.308.8 NMAC, MEMBERproposed2026-08-01

Frequently asked questions

Where does New Mexico publish its Medicaid fee schedules?

New Mexico publishes rates across 49 official documents (fee schedules, rate notices and bulletins). Every rate on this page links to its source document.

How many Medicaid rates does New Mexico publish?

31,727 rates are current across 140 services and 9 programs, with 32,249 versions on record since 2005-01-01.

Do New Mexico Medicaid managed-care plans pay the fee schedule?

For 22 of 22 service lines, plan contracts or state law set a rule plans must follow (a floor, a state-set rate or a required pass-through). For the rest, plans negotiate. See the managed-care page for each line's rule and citation.

Other states

Your New Mexico rate cardYour codes, what New Mexico pays, what plans must pay, and every change in 2026.
Medicaid rates by state