New Mexico Administrative Code
Title 8 - SOCIAL SERVICES
Chapter 301 - MEDICAID GENERAL BENEFIT DESCRIPTION
Part 6 - CLIENT MEDICAL TRANSPORTATION SERVICES
Section 8.301.6.12 - OUT-OF-STATE TRANSPORTATION AND RELATED EXPENSES
Current through Register Vol. 35, No. 6, March 26, 2024
All out-of-state transportation, meals and lodging must be prior approved by MAD. Out-of-state transportation is approved only if the out-of-state medical service is approved. Documentation must be available to the reviewer to justify the out-of-state travel and verify that treatment is not available in the state of New Mexico.
A. Requests for out-of-state transportation must be coordinated through the MAD client services bureau or MAD's designated contractor.
B. Authorization for lodging and meal services by out-of-state providers can be granted for up to 30 calendar days by MAD. Re-evaluation authorizations are completed prior to expiration and every 30 days, thereafter.
C. Transportation to border cities, those cities within 100 miles of the New Mexico border (Mexico excluded), are treated as in-state provider service. An eligible recipient who receives MAD reimbursable services from a border area provider is eligible for transportation services to that provider. See 8.302.4 NMAC, Out of State and Border Area Providers, to determine when a provider is considered an out-of-state provider or a border area provider.
