N.M. Admin. Code § 8.325.9.14

Current through Register Vol. 36, No. 1, January 14, 2025

Section 8.325.9.14 - NONCOVERED SERVICES

Home health services are subject to the limitations and coverage restrictions of other medicaid services. See 8.301.3 NMAC, General Noncovered Services. Medicaid does not cover the following home health agency services:

A. services beyond the initial evaluation which are furnished without prior approval;

B. home health services which are not skilled, intermittent and medically necessary;

C. services furnished to recipients who do not meet the eligibility criteria for home health services;

D. services furnished to recipients in places other than their place of residence;

E. services furnished to recipients who reside in intermediate care facilities for the mentally retarded or nursing facility (NF) residents who require a high NF level of service. Physical, occupational and speech therapy can be furnished to residents of nursing facilities who require a low level of service.

F. skilled nursing services which are not supervised by registered nurses; and

G. services not included in written plans of care established by physicians in consultation with the home health agency staff.

N.M. Admin. Code § 8.325.9.14

2/1/95; Recompiled 11/30/01, Adopted by New Mexico Register, Volume XXXV, Issue 12, June 25, 2024, eff. 7/1/2024