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MedicaidBilling CodesMedium impact

Supplement 25-07: Birthing Options Program Billing & Reimbursement Replaces Supplement 19-02

New Mexico Medicaid·NM · OB-GYN·Claims & Billing
Effective date
Apr 1, 2025
We identified it
Jun 21, 2026
Days to comply

Summary

New Mexico Medicaid updated billing procedures for the Birthing Options Program (BOP), replacing 2019 guidance with standardized billing for midwife providers and licensed birth centers. The policy clarifies split billing models, specific procedure codes, and documentation requirements for out-of-hospital births.

Action Required

Action needed
New Mexico Medicaid providers: Update billing procedures for birthing options program to use split billing model for licensed birth centers (UB/837I format with bill type 841 for facility charges, CMS 1500/837P for professional services). Ensure MAD 318 forms are completed by recipients and attached to all claims. Update revenue codes to use 0724 for labor/delivery and 0729 for transfers. Verify midwife provider enrollment includes required documentation (MAD 316, MAD 317 forms).

Affected Billing Codes

59400
59410
59610
59614
S4005
59899
99070
J2790
90384
59425
59426