New Mexico Medicaid State-Specific Services Fee Schedule 2026

New Mexico Medicaid publishes 525 state-specific and temporary HCPCS code rates effective 2026, paying a median 140.8% of the national Medicare amount for the same services. This page lists the Q, S, T and C codes New Mexico prices outside its standard categories, with plain-language descriptions and, where a comparator exists, each rate as a percentage of national Medicare. It is one category of the New Mexico Medicaid fee schedule (9 categories).

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The table on this page is a common-procedure sample. The full New Mexico state-specific services schedule has 525 codes.

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Published codes

525

state-specific and temporary HCPCS codes on the 2026 schedule

Median % of Medicare

140.8%

vs national Medicare, GPCI-neutral

Effective vintage

2026

latest effective year on the schedule

Common state-specific and temporary HCPCS codes and what New Mexico Medicaid pays

A curated sample of recognizable procedures from the 525-code schedule. Rates are the state's published fee-for-service amounts; the percentage compares each rate with the national Medicare amount for the same code.

CodeProcedureNew Mexico rate% of Medicare
S5125Attendant care services; per 15 minutes$8.42--
T1015Clinic visit/encounter, all-inclusive$122.47*--
T2021Day habilitation, waiver; per 15 minutes$5.93--

Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * show the schedule's representative published variant.

More New Mexico Medicaid fee schedules

State-Specific Services rates in neighboring states

Frequently asked questions

What does New Mexico Medicaid pay for state-specific and temporary HCPCS services?

New Mexico Medicaid publishes 525 state-specific and temporary HCPCS code rates effective 2026, paying a median 140.8% of the national Medicare amount for the same services. The schedule covers clinic and screening encounters, telehealth facility fees, personal care, and other C, Q, S and T codes. The table on this page shows published rates for common procedures; the complete all-codes schedule is available as a CSV download with a ProviderSignal Rates subscription.

How do New Mexico's state-specific services rates compare with Medicare?

Across state-specific services codes with a national Medicare comparator, New Mexico Medicaid pays a median 140.8% of the Medicare amount (GPCI-neutral national comparison). Individual codes vary widely, so check the per-code percentage in the table.

Do state-specific and temporary HCPCS services need prior authorization in New Mexico?

New Mexico does not publish prior-authorization indicators on this fee schedule, so PA requirements must be confirmed through the state's provider manual or portal. Absence of a flag here means "not published", never "no PA required".

Where do these rates come from?

Directly from New Mexico's published Medicaid fee-for-service schedule (effective 2026), collected and normalized by ProviderSignal across all 50 states + DC. Rates are re-collected on a rolling schedule and this page updates automatically. Procedure descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.