MedicaidCoverageMedium impact
Supplement 25-14: Billing and Reimbursement for Traditional Health Care Practices (THCP)
New Mexico Medicaid·NM · Family Medicine, Internal Medicine, General Practice·Claims & Billing
Effective date
Oct 1, 2025
We identified it
Jun 21, 2026
Summary
New Mexico Medicaid now covers Traditional Health Care Practices (THCP) for Native American members effective October 1, 2025. Providers must enroll as Provider Type 221 through YesNM Portal and can bill using specific procedure codes H0051 (Traditional healer) and T1016 (Natural helper) at OMB rates.
Action Required
IHS, Tribal 638 facilities, and Urban Indian Health Centers must: 1) Enroll as Provider Type 221 through YesNM Portal at https://yes.nm.gov/nmhr/s/providers-and-ped?language=en_US, 2) Update billing systems to include procedure codes H0051 (Traditional healer) and T1016 (Natural helper), 3) Use taxonomy code 282N00000X and appropriate revenue codes (0919, 0519, 0529), 4) Submit claims on UB-04 forms for AI/AN recipients and CMS 1500 for non-AI/AN recipients, 5) Verify Medicaid eligibility before providing services. Services are reimbursed at OMB rate with no prior authorization required.