N.M. Admin. Code § 8.312.2.13

Current through Register Vol. 35, No. 23, December 10, 2024

Section 8.312.2.13 - COVERED SERVICES

A. MAD covers NF services identified as allowable costs; see 8.312.3 NMAC.

B. MAD covers physical, occupational and speech therapy services furnished to an eligible recipient or member residing in a NF in the following manner:

(1) if the eligible recipient or member is also eligible for medicare and the NF does part B billing, the co-payment or deductible is processed by MAD or the MCO for services is paid by MAD or the MCO;

(2) if the eligible recipient or member receives high NF level services, services are included in the MAD facility rate; or

(3) if eligible, the recipient or member receives low NF level services, services are billed separately by participating therapy providers.

N.M. Admin. Code § 8.312.2.13

8.312.2.13 NMAC - Rp, 8.312.2.13 NMAC, 8/1/14