This page includes the prior authorization summaries and code list documents that were previously posted.
2023 Procedure Code Lists Effective 01/01/2023
- 2023 Behavioral Health Procedure Codes Requiring Prior Authorization for Fully Insured and Administrative Services Only (ASO) Members Effective 01/01/2023 through 09/17/2023
- 2023 Commercial Specialty Pharmacy Prior Authorization Drug List_NM
- 2023 Commercial Specialty Pharmacy Prior Authorization Drug List for Fully Insured and Administrative Services Only (ASO) Members Effective 01/01/2023 through 09/17/2023
- 2023 List of Service Categories Requiring Prior Authorization
- 2023 New Mexico Medicaid Procedure Codes Requiring Prior Authorization
- 2023 Outpatient Medical/Surgical Procedure Codes Requiring Prior Authorization for Administrative Services Only Members
- 2023 Outpatient Medical/Surgical Procedure Codes Requiring Prior Authorization for Fully Insured Members
- 2023 Outpatient Medical/Surgical Procedure Codes Requiring Prior Authorization for Fully Insured Members Effective 01/01/2023 through 09/17/2023
- 2023 Recommended Clinical Review List
- 2023 Summary of Medical/Surgical and Behavioral Health Services, and Specialty Pharmacy Drugs Requiring Prior Authorization for Fully Insured and Administrative Only (ASO) Members Effective 01/01/2023 through 09/17/2023
2023 Procedure Code Lists Effective 02/01/2023
- 2023 Commercial Procedure Code Lookup for commercial members
- 2023 List of Service Categories Requiring Prior Authorization
- 2023 Recommended Clinical Review List
2023 Procedure Code Lists Effective 03/01/2023
2023 Procedure Code Lists Effective 04/01/2023
- 2023 Commercial Specialty Pharmacy Prior Authorization Drug List_NM
- 2023 List of Service Categories Requiring Prior Authorization
- 2023 New Mexico Medicaid Procedure Codes Requiring Prior Authorization
- 2023 Outpatient Medical/Surgical Procedure Codes Requiring Prior Authorization for Administrative Services Only Members
- 2023 Outpatient Medical/Surgical Procedure Codes Requiring Prior Authorization for Fully Insured Members
- 2023 Recommended Clinical Review List
2023 Procedure Code Lists Effective 05/01/2023
2023 Procedure Code Lists Effective 06/01/2023
- 2023 Commercial Procedure Code Lookup for commercial members
- 2023 Commercial Specialty Pharmacy Prior Authorization Drug List_NM
- 2023 Outpatient Medical/Surgical Procedure Codes Requiring Prior Authorization for Administrative Services Only Members
- 2023 Outpatient Medical/Surgical Procedure Codes Requiring Prior Authorization for Fully Insured Members
- 2023 Recommended Clinical Review List
2023 Procedure Code Lists Effective 07/01/2023
- 2023 Commercial Procedure Code Lookup for commercial members
- 2023 Commercial Specialty Pharmacy Prior Authorization Drug List for Administrative Services Only (ASO) Members
- 2023 Commercial Specialty Pharmacy Prior Authorization Drug List for Fully Insured and Administrative Services Only (ASO) Members
- 2023 New Mexico Medicaid Procedure Codes Requiring Prior Authorization
- 2023 Outpatient Medical/Surgical Procedure Codes Requiring Prior Authorization for Administrative Services Only (ASO) Members
- 2023 Outpatient Medical/Surgical Procedure Codes Requiring Prior Authorization for Fully Insured Members
- 2023 Recommended Clinical Review List
2023 Procedure Code Lists Effective 08/01/2023
- 2023 Commercial Procedure Code Lookup for commercial members
- Recommended Clinical Review - Administrative Services Only (ASO)
- Recommended Clinical Review - Fully Insured
- Recommended Clinical Review - Fully Insured and Administrative Services Only (ASO)
2023 Procedure Code Lists Effective 09/01/2023