New Mexico Administrative Code
Title 8 - SOCIAL SERVICES
Chapter 302 - MEDICAID GENERAL PROVIDER POLICIES
Part 2 - BILLING FOR MEDICAID SERVICES
Section 8.302.2.14 - BILLING AND PAYMENT LIMITATIONS
Current through Register Vol. 35, No. 6, March 26, 2024
A. Payment not allowed: MAD does not pay factors either directly or by power of attorney 42 CFR Section 447.10(h). A factor is an individual or an organization, such as a collection agency or service bureau.
B. No reimbursement for the discharge day: An institutional or other residential provider, such as a NF, a hospital, an ICF-IID, and a provider of treatment foster care services are reimbursed for services furnished to an eligible recipient or member on the day of admission but are not reimbursed for services furnished on day of discharge.
C. No payment made for wrong services: A provider shall not bill MAD for:
D. Payments for acquired conditions: MAD may deny or limit payment on claims for services to treat an eligible recipient or member for a condition acquired during the course of a facility stay or in the rendering of other services.
