N.M. Admin. Code § 8.325.9.18

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

Section 8.325.9.18 - REIMBURSEMENT LIMITATIONS

The following limitations apply to reimbursement made to home health agencies:

A. allowable costs are determined according to medicare and Title XIX (medicaid) reimbursement regulations;

B. the established percentage relationship of the agency's cost to charges per unity of services includes all services;

C. out-of-state providers are reimbursed at seventy percent of billed charges. Out-of-state home health services are approved only in very unusual circumstances, since home health services are furnished in the recipient's residence and that residence must be in New Mexico; and

D. claims for approved home health services must include the types of visits, dates of visits and number of visits.

N.M. Admin. Code § 8.325.9.18

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