New Mexico Medicaid

MedicaidNM

ABA billing requirements · Source: New Mexico HCA — Applied Behavior Analysis FAQ

Low confidence

Verified 2026-03-01

Authorization Requirements

Requires prior auth Yes

Initial auth durationN/A

Renewal auth durationN/A

Submission deadlineN/A

Unit tracking cadenceTotal

Requires FBA Yes

Diagnostic eval validityN/A

Re-eval cadenceN/A

State licensure requiredBCBA state licensure required via NM Board of Psychologist Examiners

Documentation Requirements

Parent signatures required Yes

Start/stop times required Yes

Treatment plan componentsBaseline data, Target behaviors, Methods

Progress summary cadenceEvery 6 months

Policy Notes

Medicaid policy is silent on allowable settings for ABA services in schools. Services in schools that supplant educational services are non-covered. Schools do not bill for ABA services; ABA providers bill through their own mechanisms. ABA services are not eligible for Medicaid reimbursement as a related service for IEPs.

CPT & Modifier Rules

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View H-codes, modifiers, unit limits, and billing restrictions for New Mexico Medicaid.

Official policy source:New Mexico HCA — Applied Behavior Analysis FAQ

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Data last verified: 2026-03-01 · Confidence: Low · See our methodology

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