PROVIDERS
The Health Care Authority’s mission is: We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services.
Get Ready to Revalidate! Medicaid Provider Revalidation Begins in June. Click here to sign up for training: NM Provider Training Schedule May-June 2026
Providers Overview
The Health Care Authority’s Medical Assistance Division oversees Medicaid provider enrollment, re-enrollment, and re-validation. Medical providers (including hospitals and private practitioners) and managed care organizations can find valuable provider resources here.
Find communications from the Medicaid director on the Communications to Providers web page.
Learn about the Provider Enrollment and Presumptive Eligibility Determiner system.
Learn about Critical Incident Reporting requirements and protocols.
Learn how to become a Presumptive Eligibility Determiner to help eligible individuals enroll in Medicaid.
Find Fee-for-Service fee schedules and Medicaid services for Native Americans.
For questions or concerns, please contact the Consolidated Customer Service Center at 1-800-299-7304
Find the New Mexico Medicaid PDL https://www.hca.nm.gov/preferred-drug-list/
For questions on the PDL please contact the Conduent Pharmacy Help Desk at 1-800-365-4944 Opt. 3
Home and Community Based providers who wish to serve members can find out more on the Agency Based Community Benefits (ABCB) Program web page and in the Medicaid Managed Care Policy Manual.
National Uniform Claim Committee (NUCC) taxonomy matrix for all payers: Provider Enrollment Matrix (06/23/2026)