Ordering, Referring, Prescribing and Attending Providers Must Enroll as Medicaid Providers
Beginning July 1, 2026, claims for services rendered, ordered, or prescribed by providers who are not enrolled with Medicaid will be denied and the rendering provider’s claim will not be paid.
This requirement includes pharmacists, attending physicians, those practicing within group practices, hospital systems, facilities, behavioral health agencies, Indian Health Services, and other organizational providers.
By ensuring providers who refer Medicaid members are enrolled, Medicaid is able to verify credentials, maintain up-to-date provider information, and ensure that payments are made only for services delivered by qualified, enrolled practitioners.
What Providers Need to Do:
- Review your roster of all clinicians rendering Medicaid services.
- Confirm that each rendering provider is individually enrolled in Medicaid.
- Submit a provider enrollment application at YESNM.gov as soon as possible for any rendering, ordering or prescribing (including pharmacists) provider not currently enrolled. To create a YESNM.gov account follow these instructions.
Questions? Contact the Provider Customer Service Center at 1-800-299-7304.
