N.M. Admin. Code § 8.310.9.13

Current through Register Vol. 35, No. 17, September 10, 2024

Section 8.310.9.13 - NON-CORE MEDICAL SERVICES

Core medical services, as defined in the Rural Health Clinic Act, performed at rural health clinics are included in the encounter rate for purposes of medicaid reimbursement. The following non-core services may be provided in rural clinics, however, reimbursement for these services is not included in the encounter rate:

A. optometric services, including vision examinations and eyeglasses dispensing;

B. hearing aid dispensing and related evaluations;

C. psychological services;

D. rural health drug services; and

(1) pharmacy services are covered by medicaid if the rural health clinic obtains a separate pharmacy provider number; a separate New Mexico medical assistance program provider participation application must be submitted for pharmacy services and be approved by MAD;.

(2) pharmacy dispensing services must be billed with the separate pharmacy provider number;.

(3) the rural health clinic pharmacy must be licensed by the state pharmacy board; see 8.324.4 NMAC, Pharmacy Services.

E.Rural health dental services:

(1) Certified rural health clinics may participate as rural health dental providers if they obtain a separate dental provider numbers. A separate New Mexico medical assistance program provider participation application must be submitted by a rural health center dental provider and be approved by MAD.

(2) Dental services must be billed under the separate dental provider number, not the rural health clinic provider number. See 8.310.7 NMAC, Dental Services.

N.M. Admin. Code § 8.310.9.13

8.310.9.13 NMAC - Rp, 8.310.3.13 NMAC, 1-1-14