PROVIDERS
The Health Care Authority’s mission is: We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services.
- Providers Overview
- Abbreviations / Acronyms / Glossary of Terms
- Communications to Providers
- New Provider & PED Enrollment System
- Critical Incident Reporting
- Fee for Service
- Manuals and Guides
- New Mexico Administrative Code Program Rules and Billing
- Native Americans
- PE/MOSAA Determiners
- Sites of Interest
- ABA (Applied Behavior Analysis) Provider Information
- The Connections App
- NM OpenBeds
- GME Expansion
Pharmacy Benefit Contacts
New Mexico Medicaid
Pharmacy Benefit Billing & Contact Information
FEE-FOR-SERVICE
Turquoise Care: Conduent
For Members/Providers
- Prior Authorization form
- Phone Numbers
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- Provider: 1-800-299-7304
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- Members: 1-800-283-4465
For Pharmacies
- Point of Sale Help Desk: 1-800-365-4944
- Prescription Information
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- PBM Name: Conduent
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- BIN: 610084
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- PCN: DRNMPROD
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- Group: NEWMEXMED
MANAGED CARE
Blue Cross Blue Shield of New Mexico: Prime Therapeutics
For Members/Providers
- Prior Authorization form
- Phone Numbers
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- Provider: 1-800-693-0663
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- Members: 1-866-689-1523
For Pharmacies
- Point of Sale Help Desk: 1-888-840-3044
- Prescription Information
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- PBM Name: Prime Therapeutics
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- BIN: 011552
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- PCN: SALUD
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- Group: N72100-N/A
Presbyterian Health Plan: Capital Rx
For Members/Providers
- Prior Authorization form
- Phone Numbers
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- Provider: 505-923-5757 or
- 1-888-923-5757
- Members: 505-923-5200 or
- 1-888-977-2333
For Pharmacies
- Point of Sale Help Desk: 1-866-528-5829, option 2
- Prescription Information
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- PBM Name: Capital RX
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- BIN: 610744
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- PCN: CRXMC
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- Group: PHPCAID
Molina Healthcare of New Mexico: CVS Caremark
For Members/Providers
- Prior Authorization form
- Phone Numbers
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- Provider:1-855-322-4078, option 0, then option 1, then option 2
- Members: 1-844-862-4543, option 1, then option 3
For Pharmacies
- Point of Sale Help Desk: 1-833-249-8392
- Prescription Information
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- PBM Name: CVS Caremark
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- BIN: 004336
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- PCN: MCAIDDV
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- Group: RX51EA
United Healthcare Community Plan of New Mexico: Optum Rx
For Members/Providers
- Prior Authorization form
- Phone Numbers
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- Provider: 1-888-702-2202 or
- 1-800-970-3887
- Members: 1-877-236-0826
For Pharmacies
- Point of Sale Help Desk: 1-800-970-3887
- Prescription Information
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- PBM Name: Optum Rx
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- BIN: 610494
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- PCN: 4941
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- Group: ACUNM
Contact MADInfo.HCA@hca.nm.us with questions or for more information.