How to start an IDD waiver provider in New Mexico

New Mexico requires a DD Waiver Provider Agreement (DDSD Provider Enrollment & Relations Unit approval) from New Mexico Health Care Authority (HCA), Developmental Disabilities Supports Division (DDSD) - Provider Enrollment & Relations Unit (PERU) to operate an IDD waiver provider. Processing time: HCA says the application process takes approximately 90 days.

License required

Yes

License

DD Waiver Provider Agreement (DDSD Provider Enrollment & Relations Unit approval)

Issuing agency

New Mexico Health Care Authority (HCA), Developmental Disabilities Supports Division (DDSD) - Provider Enrollment & Relations Unit (PERU)

Processing time

HCA says the application process takes approximately 90 days.

Insurance and bonds

Provider Agreement Article 24 requires a fidelity bond covering employee dishonesty and failure to account for funds; Article 25 requires liability insurance naming HCA as additional insured, minimum $1,000,000 per occurrence for bodily injury and property damage (different terms for agreements under $100,000). Policies are sent to PERU annually.

Regulation

DD Waiver Provider Agreement (Articles 24-25)

1. Complete the DD Waiver Provider Application (or Qualified Provider Application) from the HCA Provider Enrollment & Relations page
2. Address HCBS settings rule compliance in application answers and policies
3. Obtain the required fidelity bond and liability insurance naming HCA as additional insured
4. Sign the DD Waiver Provider Agreement and enroll with New Mexico Medicaid
5. Keep PERU updated annually with insurance, professional licenses, board list and annual report

Program

New Mexico Medicaid / Turquoise Care (New Mexico Health Care Authority, Medical Assistance Division)

Enrollment portal

Provider & PED Enrollment System at YES.NM.GOV

Application fee

Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts. HCA's enrollment pages do not list a separate state fee.

Fingerprinting

HCA's Provider Enrollment Matrix flags fingerprints as mandatory for home health agencies, DME/medical supply providers, prosthetists/orthotists, and private and state nursing facilities. Under federal rules (42 CFR 455.434 and 455.450), the state places provider types in 'limited', 'moderate' or 'high' risk levels. High-risk providers, and anyone who owns 5% or more of one, must submit fingerprints for a criminal background check.

Site visit

HCA's Provider Enrollment Matrix flags a mandatory site visit for some entries of these types: ground ambulance, home health agencies, hospice, clinical and diagnostic laboratories, DME/medical supply providers, physical therapists, LMFTs, and prosthetists/orthotists. Under federal rule (42 CFR 455.432), the state must visit moderate- and high-risk providers before and after enrollment. Every enrolled provider must allow unannounced on-site inspections.

Revalidation

New Mexico revalidates every three years, which is more often than the federal 5-year minimum. Revalidation is rolling and restarted in June 2026. A selected provider gets a 60-day notice, logs in to YES.NM.GOV, updates the record, uploads the documents listed in the Provider Enrollment Matrix, and submits. A provider who does not revalidate can be disenrolled. Expiring licenses and certifications are updated separately through a Recertification application.

Full New Mexico Medicaid enrollment guide →

CON program

No

Agency

New Mexico Health Care Authority, Division of Health Improvement (facility licensing only)

New Mexico certificate of need details →

Model

state-sponsored

State vendor

Fiserv AuthentiCare

Services in scope

• personal care
• respite
• home health

Alternate EVV allowed

Yes

Program

https://www.hca.nm.gov/wp-content/uploads/Final-LOD-58-EVV-Aggregator.pdf

New Mexico EVV requirements →

State minimum wage

$12.00 an hour

Effective

2023-01-01

Scheduled increases

No scheduled change found in the official sources reviewed.

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Intellectual/developmental disability residential facilities — active organization NPIs (NPPES)

88 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

673,265 (as of Jun 1, 2026)

All New Mexico IDD / waiver Medicaid rates, ranked →

• NM Developmental Disabilities Waiver Program (1915(c))
• NM Medically Fragile Waiver (1915(c))
• NM Mi Via - ICF/IDD Waiver (1915(c))
• New Mexico Turquoise Care (formerly New Mexico Centennial Care 2.0) (1115)

New Mexico waivers and waiting lists →