New Mexico Administrative Code
Title 8 - SOCIAL SERVICES
Chapter 325 - SPECIALTY SERVICES
Part 9 - HOME HEALTH SERVICES
Section 8.325.9.17 - REIMBURSEMENT

Home health agencies assume responsibility for any and all claims submitted on behalf of the provider and under the provider's number. Home health agencies must submit claims for reimbursement on the UB-92 claim form or its successor. See 8.302.2 NMAC, Billing for Medicaid Services. Once enrolled, providers receive instructions on documentation, billing and claims processing. Reimbursement is made based on the Title XVIII (medicare) cost-finding procedures and reimbursement methodology. Charges are paid at an interim rate basis established under the medicaid guidelines by the medicare audit agent, subject to retroactive settlement when the cost report is final. Cost reports on appropriate forms must be submitted to the audit agent within 90 days of the close of the provider's fiscal accounting period. Failure to provide timely cost reports results in suspension of payments.