Health Care Authority News:

• • • • • Some services raised to 150% of Medicare rates

SANTA FE – The Health Care Authority (HCA) announced today that some Medicaid provider rates increased effective Jan. 1, as part of Gov. Michelle Lujan Grisham’s ongoing efforts to strengthen health care access across the state.

The adjustments aim to support providers delivering services to Medicaid patients.

“This increase is an important step in building a stronger partnership with health care providers who serve Medicaid members,” Medicaid Director Dana Flannery said. “By investing in our providers, we are strengthening access to critical health care services like primary care, maternal, and behavioral health for New Mexicans.”

The new rate increases include behavioral health, primary care, and maternal/child health services, with many rising to 150% of the Medicare 2024 benchmarks. New Mexico’s Medicaid rates are already among the highest for some billing codes, but these increases demonstrate the state’s commitment to improving health care outcomes.

In addition:

• Behavioral health services rates without a Medicare equivalent have increased.
• Hospitals serving a high percentage of Native American patients will see rate increases ranging from 13% to 33%.
• Medicaid managed care organizations are directed to match the updated Medicaid Fee-for-Service rate codes without a Medicare equivalent.
  

The updated Medicaid Fee-for-Services rate schedule, effective Jan. 1, 2025, reflects these changes.

For more information, see the Fee Schedule Updates on the HCA website.