New Mexico Prior Authorization Requirements

A guide to prior authorization rules, turnaround times, and laws for medical practices operating in New Mexico (NM).

PA Turnaround Times

Standard Requests

14 calendar days

Urgent / Expedited

72 hours

Key Regulations

  • Standard PA turnaround of 14 calendar days
  • Urgent requests within 72 hours

New Mexico Medicaid PA

New Mexico Medicaid (Centennial Care) uses managed care. PA is administered by the MCOs.

Top Payers in New Mexico

Blue Cross Blue Shield of New MexicoPresbyterian Health PlanUnitedHealthcareMolina Healthcare

State Regulatory Body: New Mexico Office of Superintendent of Insurance

File PA complaints or appeals through your state insurance department.

Automate PA in New Mexico

Greenlight knows every payer's PA requirements in New Mexico and checks them automatically before every appointment -- so your staff does not have to.

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