April 14, 2025
What to know: On Jan. 29, 2025, the Health Care Authority issued Letter of Direction #50 – Pharmaceutical Service Reimbursement concerning parity of reimbursement for pharmacy providers outlined in New Mexico House Bill 42.
Certain services rendered by a pharmacist clinician or a pharmacist with prescriptive authority billed with a place of service of an office, clinic, pharmacy, long term care, hospital or any outpatient settings are covered under Turquoise Care. Services are reimbursed at the same rate as the rate paid to other medical providers. Learn more about billing and reimbursement requirements.
Requirements: Pharmacy providers need to be enrolled and credentialed with Turquoise Care and Blue Cross and Blue Shield of New Mexico to receive reimbursement.
Providers not already enrolled with Turquoise Care will need to do so prior to requesting to join our network. Learn more on how to enroll with HCA and BCBSNM.
Please contact your Network Representative if you have questions.