April 6, 2026
The New Mexico Health Care Authority launched Turquoise Claims on March 23, 2026, replacing Omnicaid and the New Mexico Medicaid Portal. This new system changes how we process claims for members of Turquoise Care.
Review updated claims processing information:
- Providers must use the appropriate taxonomy for the billing, rendering and attending provider’s National Provider Identifier in accordance with the HCA Provider Matrix.
- Continue to use the same payer ID you submit for an electronic claim for Turquoise Care claims.
- Continue to submit paper claims on the CMS-1500 (Physician/Professional Provider) or CMS-1450 (UB-04) claim form to:
Medicaid
P.O. Box 650712
Dallas, TX 75265-0712
- Continue to submit claims that don’t require attachments for processing electronically through Availity® Essentials.
- Use the appropriate 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.
- Use the appropriate 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.
You may see updated processing explanation codes on your payment remittance based on the new system configuration.
Reminders when billing Turquoise Care claims:
- Ensure the NPI is actively enrolled with Turquoise Care for the date of service billed on the claim.
- There is no change in payer ID or loop segment for BCBSNM.
- Ensure that the member’s last name and date of birth match the Turquoise Claims portal exactly.
- Include the full nine-digit ZIP code.
- Apply valid and applicable modifiers.
- Verify that member data matches the member ID card and Medicaid portal.
We require the appropriate taxonomy code representative of a provider’s type and specialty to be reported for each billing, rendering and attending provider defined on the claim. Review the MCO Turquoise Claims Manual and the HCA Provider Matrix to confirm you are using the appropriate taxonomy code based on the provider type and specialty or category of service you are registered with for New Mexico Medicaid. Failure to report the appropriate taxonomy code may result in claim rejections or denials beginning June 15, 2026.
For vendor options and information, refer to electronic commerce information.
To submit claims inquiries, disputes and service authorization disputes for Turquoise Care: Continue to call 800-693-0663 to submit a provider claim inquiry or dispute by phone. Updated inquiry or dispute forms will be available on our website.
Watch News and Updates for information about ongoing changes to our program for Turquoise Care. Contact our Provider Network team if you have questions or need assistance.
To sign up for training, log in to your YES.NM.GOV account, then select the Learning Management System link.
If you have not created an account, follow these step-by-step instructions. For more information, visit HCA’s Turquoise Claims website.