The State of New Mexico Office of the Superintendent of Insurance has issued a bulletin regarding the utilization of reimbursement of telemedicine during the COVID-19 pandemic.
The New Mexico Behavioral Health Collaborative has issued a Letter of Direction regarding Falling Colors and behavioral-health telephonic visits.
The New Mexico Human Services Department’s Medical Assistance Division has issued a Letter of Direction for Centennial Care 2.0 Managed Care Organizations for modification of services and program standards.
The delivery of health care via telehealth is recognized and encouraged as a safe, practical and necessary practice in New Mexico. No health care provider or operator of an originating site shall be disciplined for or discouraged from participating in telehealth pursuant to the New Mexico Telehealth Act. In using telehealth procedures, health care providers and operators of originating sites shall comply with all applicable federal and state guidelines and shall follow established federal and state rules regarding security, confidentiality and privacy protections for health care information. TeleHeath PDF
New Mexico reimburses for live video as part of telemedicine. NM Stat § 59A-22-49.3 (2013)
Unique CPT codes do not exist specifically for telemedicine or telehealth. Instead a modifier is applied to existing codes.
B. Group health coverage, including any form of self-insurance, offered, issued or renewed under the Health Care Purchasing Act shall provide coverage for services provided via telemedicine to the same extent that the group health plan covers the same services when those services are provided via in-person consultation or contact. A group health plan shall not impose any unique condition for coverage of services provided via telemedicine.
I. A group health plan shall reimburse for health care services delivered via telemedicine on the same basis and at least the same rate that the group health plan reimburses for comparable services delivered via in-person consultation or contact.
New Mexico SB 354 Effective June 14, 2019
Telemedicine providers: Reimbursement for professional services at the originating-site and the distant-site are made at the same rate as when the services provided are furnished without the use of a telecommunication system. In addition, reimbursement is made to the originating-site for an interactive telemedicine system fee at the lesser of the provider’s billed charge; or the maximum allowed by MAD for the specific service or procedure.