Provider FAQs on Senate Bill 249

The following are frequently asked questions regarding New Mexico Senate Bill 249 (2025) and its impact on payments contracted Medicaid providers will receive from Blue Cross and Blue Shield of New Mexico. Effective Jan. 1, 2026, this law requires BCBSNM to reimburse contracted Medicaid health care providers for all applicable gross receipts taxes that the provider is required to pay for contracted health care services furnished to BCBSNM’s Medicaid members.

Please note that this is not and we do not provide tax advice. We recommend consulting with a qualified tax professional or the New Mexico Taxation and Revenue Department for guidance specific to your practice.

We may update the FAQs periodically to reflect changes.

  • FAQs
     
    Q: What is SB 249 and what does it entail?
    A: SB 249 is a New Mexico state law that requires Blue Cross and Blue Shield of New Mexico to reimburse contracted Medicaid health care providers, including telehealth providers, for all applicable gross receipts taxes that the provider is required to pay for contracted health care services. SB 249 requires BCBSNM to provide documentation that differentiates the GRT paid to the contracted health care provider from the Medicaid reimbursement for health care services.
    Q: What services qualify for the GRT reimbursement under SB 249?
    A: SB 249 applies to payments for health care services provided by a contracted Medicaid health care provider that is required to pay GRT to the State of New Mexico.
    Q: How will GRT be calculated?
    A: BCBSNM will calculate GRT based on the location where the service was rendered. In order for us to calculate and reimburse GRT accurately, contracted providers must populate the claim service address field on their claims. When the provider fails to populate the claim service address field, the GRT rate will default to the state-only GRT rate.
    Q: How will GRT payments be remitted?
    A: Contracted Medicaid providers will receive a separate payment from BCBSNM for GRT.
    Q: Will the billing process be impacted?
    A: BCBSNM is not currently requiring any changes to billing processes for the implementation of SB 249 for providers contracted with us for New Mexico Medicaid.
    Q: How will claims be processed?
    A: BCBSNM requires New Mexico Medicaid providers to populate the appropriate claim service address on each claim in order to accurately calculate GRT reimbursement. GRT will be separately calculated, paid and documented outside of the claims process.
    Q: Will GRT be reflected on our Provider Claims Summary?
    A: No, contracted providers will receive a separate statement with the GRT payment amount.
    Q: Do providers need to use a new modifier or tax code on claims to BCBSNM?
    A: No, we do not plan to implement new modifiers or codes related to SB 249.
    Q: How will BCBSNM help providers identify the services to which BCBSNM applied GRT?
    A: The separate statement from BCBSNM will cover eligible Medicaid health care services for claims processed in the one-week period prior to the payment date on your check or electronic fund transfers. GRT statements for paper check and EFT payments include claim-line level details related to provider GRT reimbursements. GRT statements are available online through the Availity® Essentials' Provider Correspondence Viewer.
    Q: Will BCBSNM amend provider contracts under SB 249?
    A: We reached out to providers whose participation contracts were determined to need a contract amendment related to SB 249. We aren't aware of additional contracts needing an amendment.
    Q: How does the GRT reimbursement affect out- of- state telehealth providers?
    A: According to the New Mexico Taxation & Revenue Department, a person or business lacking physical presence in New Mexico is required to pay GRT to the State of New Mexico in the current year, if in the previous calendar year they had total taxable gross receipts of at least $100,000 from sales, leases and licenses of tangible personal property, sales of licenses and sales of services and licenses for use of real property sourced to New Mexico pursuant to Section 7-1-14 NMSA 1978 (“Economic Nexus Threshold”). If Medicaid-contracted providers were paid less than the Economic Nexus Threshold by BCBSNM in the prior calendar year to receive GRT from BCBSNM in the current calendar year, those providers must sign and return the New Mexico GRT Economic Nexus Attestation form to their assigned BCBSNM Provider Network Representative. 

If you have additional questions, please reach out to your assigned Provider Network Representative.