April 6, 2026
In February, we alerted you of claims processing changes and billing reminders for Turquoise Care. To align with New Mexico Medicaid billing requirements, it’s important that you submit claims with appropriate taxonomy codes to identify the provider type and specialty. This applies to each billing, rendering or attending provider defined on the claim. As of March 23, 2026, failure to report the appropriate taxonomy code will result in claim rejections or denials. Additional details and reminders are below.
Taxonomy code attestation: Refer to the New Mexico Health Care Authority HCA Provider Matrix to confirm you’re using the appropriate taxonomy code based on the provider type and specialty or category of service that matches your registration with the New Mexico Medicaid system.
All New Mexico Medicaid providers will be required to submit the appropriate taxonomy code for the service rendered as defined by the HCA Provider Matrix.
For taxonomy codes on electronic claim submissions, ASC X12N file formats:
- 837I – The billing taxonomy code should be placed in loop 2000A, segment PRV03. The attending taxonomy code should be placed in loop 2310A, segment PRV03.
- 837P – The Billing Taxonomy code should be placed in Loop 2000A, Segment PRV03. The Rendering taxonomy code should be placed in loop 2310B, segment PRV03.
For taxonomy codes on paper claim submissions:
- UB04 Institutional Claims – The billing taxonomy code should be placed in field 81 and submitted with the “BI” qualifier. The attending taxonomy code should be placed in field 76 and submitted with the “AT” qualifier.
- CMS-1500 Professional Claims – The Billing taxonomy code should be placed in field 33b and submitted with the “BI” qualifier. The rendering taxonomy code should be placed in the shaded portion of field 24I and submitted with the “PE” qualifier.
Tips for resolving attestation denials or rejections:
- Verify enrollment with the state of New Mexico in the New Mexico Medicaid system for the dates of service on the claim.
- Verify required providers are reported on the claim. Refer to the NM Managed Care Policy Manual for requirements by provider type.
- Verify the taxonomy codes for each provider reported on the claim are appropriate for the registered provider type in the HCA Provider Matrix.
- Ensure ordering, referring or prescribing provider reporting requirements have been met on the claim. Refer to the NM Managed Care Policy Manual for requirements.
If all steps have been completed and no discrepancy is identified, contact Provider Relations for further assistance.