The purpose for the Behavioral Health Policy & Billing Manual (BH Manual) is to provide a reference for the policies and processes related to Behavioral Health for administration of Medicaid behavioral health services, as defined in New Mexico Administrative Code (NMAC), Section 8.321.2. The BH Manual will also provide supplemental material as direction for the Managed Care Organizations (MCOs).
The BH Manual was developed by the Human Services Department’s (HSD’s) Medical Assistance Division (MAD), Behavioral Health Services Division (BHSD), and the Children, Youth and Families Department (CYFD). The provisions of the BH Manual reflect the general operating policies and essential procedures specific to behavioral health services, are not all inclusive, and may be amended or revoked at any time by the HSD. If there is a conflict between the BH Manual and the NMAC rules, the NMAC rules will control.
The BH Manual will be updated on a regular basis, and HSD reserves the right to change, modify or supersede any of these policies and procedures with or without notice at any time. As policies are revised throughout the year, they will be incorporated into the BH Manual. The BH Manual may be viewed or downloaded from MAD’s home page at www.hca.nm.gov, and on the Network of Care http://newmexico.networkofcare.org/mh/. A summary list of the policy revisions will also be posted each year.
The BH Manual will be issued and maintained by HSD. It is the responsibility of all providers and entities affiliated with Medicaid in New Mexico to review, and be familiar with, the BH Manual and any amendments.
The reader should also refer to the Behavioral Health Fee Schedule which has information on providers who can bill specific procedure codes, payment information, referring and rendering provider requirements, and information on billing units.