New Mexico - Assistive Technology Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

The New Mexico Health Care Authority (HCA) Developmental Disabilities Supports Division (DDSD) approves Assistive Technology providers to deliver evaluation, devices, and training through the Developmental Disabilities (DD), Mi Via, and Medically Fragile waivers.

Applicants must secure an approved Developmental Disabilities (DD) Waiver Qualified Provider Application from DDSD before they can submit a Medicaid enrollment application through the Conduent-operated New Mexico Medicaid Portal. Once state-enrolled, providers must separately credential with Centennial Care managed care organizations to bill for services.

1. Service Definition and Scope

Assistive Technology in New Mexico encompasses devices, equipment, and specialized evaluations designed to increase or maintain the functional capabilities of waiver participants. This service aims to reduce reliance on paid staff by empowering individuals with intellectual and developmental disabilities to perform activities of daily living more independently.

The service includes the purchasing, leasing, and maintenance of equipment, as well as training for the participant and their natural supports on how to properly use the devices.

• Service Components: Evaluation, purchasing, leasing, maintenance, and training on assistive devices.
• Waiver Authorities: Funded under the Developmental Disabilities (DD) Waiver, Mi Via Waiver, and Medically Fragile Waiver.
• Exclusions: Cannot duplicate services or equipment already available and covered under the Medicaid State Plan.
• Limits: Subject to individual budget allocations and prior authorization requirements outlined in the participant's Individual Service Plan (ISP).

2. Regulatory and Oversight Agencies

The New Mexico Health Care Authority (HCA) is the primary umbrella agency overseeing Medicaid and waiver services. Within the HCA, multiple divisions handle different aspects of provider approval, enrollment, and compliance monitoring.

The Developmental Disabilities Supports Division (DDSD) manages the initial provider application, while the Medical Assistance Division (MAD) oversees Medicaid enrollment and billing.

• Developmental Disabilities Supports Division (DDSD): Manages the DD Waiver Qualified Provider Application (https://www.hca.nm.gov/developmental-disabilities-supports-division).
• Medical Assistance Division (MAD): Oversees Medicaid provider enrollment and revalidation (https://www.hca.nm.gov/providers/).
• Division of Health Improvement (DHI): Monitors compliance through Quality Management Bureau (QMB) surveys (https://www.hca.nm.gov/division-of-health-improvement/).
• New Mexico Medicaid Portal: Operated by Conduent for claims and enrollment (https://nmmedicaid.portal.conduent.com/static/ProviderInformation.htm).

3. Gatekeeping Prerequisites: Who Can Even Apply

New Mexico requires prospective waiver providers to pass a programmatic review before accessing the Medicaid enrollment portal. Funding is not guaranteed to any provider under the DD Waiver program.

Providers must also navigate managed care contracting, as Centennial Care delivers Medicaid services through managed care organizations (MCOs).

• DDSD Application Approval: An approved DD Waiver Qualified Provider Application is required prior to initiating Medicaid enrollment.
• Business Registration: Applicants must be registered and in good standing with the New Mexico Secretary of State.
• Medicaid State Plan Exhaustion: Providers must demonstrate that requested items are not covered by standard Medicaid before billing the waiver.
• Centennial Care Credentialing: Required after state enrollment; providers cannot bill without MCO credentialing committee approval.

4. Licensure and Certification Requirements

New Mexico does not issue a distinct facility license for Assistive Technology vendors through the Division of Health Improvement (DHI). Instead, providers are certified through the DDSD waiver application process.

Professionals conducting assistive technology evaluations must hold the appropriate individual occupational licenses in the state.

• Facility Licensure: Not required for standalone Assistive Technology vendors.
• DDSD Certification: Granted upon approval of the DD Waiver Qualified Provider Application.
• Professional Licensing: Evaluators (e.g., Occupational Therapists, Physical Therapists) must hold current New Mexico Regulation and Licensing Department (RLD) licenses.
• Compliance Monitoring: Subject to DHI Quality Management Bureau (QMB) surveys to ensure adherence to DD Waiver Service Standards.

5. Medicaid Provider Enrollment

After receiving DDSD approval, providers must enroll through the New Mexico Medicaid Portal operated by Conduent. This process registers the provider with the Medical Assistance Division (MAD).

Enrollment requires submission of the DDSD approval letter, NPI information, and proof of liability insurance.

• Portal: Applications are submitted via the New Mexico Medicaid Portal operated by Conduent.
• Application Fee: Subject to the federal CMS institutional application fee unless waived or paid to another state/Medicare.
• Liability Insurance: Must name the State of New Mexico Health Care Authority as an additional insured with minimum limits of $1,000,000 per occurrence.
• Revalidation: All active New Mexico providers must submit a Turn Around Document (TAD)/Reverification every three years.

6. Staffing, Training and Background Checks

Agencies providing Assistive Technology services must ensure that all staff interacting with waiver participants meet state background check and training requirements.

Evaluators must possess specific credentials to recommend specialized equipment.

• Background Checks: Caregivers Criminal History Screening (CCHS) is required for all staff with direct participant contact.
• Evaluator Qualifications: Must be licensed therapists or certified Assistive Technology Professionals (ATP) through RESNA.
• Training: Staff must complete DDSD-mandated training modules prior to delivering services.
• Universal Precautions: Staff must be trained in and utilize universal precautions during in-person evaluations or setups.

7. Documentation, Policies and Records

The DDSD application requires a comprehensive submission of agency policies. Providers must map their internal policies to the New Mexico Administrative Code (NMAC) and DD Waiver Service Standards.

Ongoing documentation must strictly align with the participant's approved Individual Service Plan (ISP).

• Policy Grid: Applicants must submit a detailed policy grid documenting the exact page numbers where NMAC standards are met.
• Device Warranties: Providers must maintain records of warranties, insurance, and maintenance plans for purchased equipment.
• Individual Service Plan (ISP): All delivered services and devices must be explicitly documented and authorized in the ISP.
• Incident Reporting: Providers must maintain policies complying with DHI incident management and reporting regulations.

8. Billing, Rates and Claims

Assistive Technology is billed according to fee schedules established by the HCA Medical Assistance Division. Because Centennial Care is a managed care system, claims are typically submitted to the participant's MCO.

Prior authorization is a strict requirement for all waiver services.

• Billing System: Claims are submitted via the New Mexico Medicaid Portal or the respective Centennial Care MCO portals.
• Prior Authorization: Required from the Third-Party Assessor (TPA) or MCO before purchasing or delivering equipment.
• Rate Setting: Established by HCA MAD fee schedules and individual budget limits.
• Fidelity Bond: Required if the Provider Agreement exceeds $100,000 (must equal 25% of the agreement amount).

9. Approval Sequence and Timeline

Becoming a fully billable provider involves a sequential process spanning state programmatic approval, Medicaid enrollment, and MCO credentialing.

The entire process can take several months, and delays at any step will pause subsequent phases.

• Step 1: Submit the DD Waiver Qualified Provider Application to DDSD.
• Step 2: DDSD review and approval (timeline varies based on application completeness).
• Step 3: Submit Medicaid enrollment via the Conduent portal (typically 60 to 90 days).
• Step 4: Complete Centennial Care MCO credentialing (typically 60 to 120 days from submission).

10. Common Denials and Survey Findings

Applications are frequently delayed or denied due to administrative errors or incomplete documentation during the initial DDSD review or the Conduent enrollment phase.

During compliance surveys, DHI QMB often cites providers for failing to maintain updated records.

• Incomplete Policy Grid: Failure to accurately map agency policies to NMAC standards in the DDSD application.
• Wrong Enrollment Type: Selecting the incorrect taxonomy or enrollment category on the Conduent portal.
• Lapsed Revalidation: Failure to submit the 3-year TAD, resulting in automatic disenrollment.
• Missing Primary Source Verification: Delays in MCO credentialing due to outdated CAQH data or unresolved licensure issues.

11. Key Contacts and Resources

Providers should utilize official state portals and helpdesks for the most current application materials and enrollment status updates.

MCO-specific credentialing questions must be directed to the individual Centennial Care plans.

• DDSD Provider Enrollment: https://www.hca.nm.gov/developmental-disabilities-supports-division
• New Mexico Medicaid Portal: https://nmmedicaid.portal.conduent.com/static/ProviderInformation.htm
• Conduent Provider Relations Helpdesk: [email protected]
• HCA Provider Enrollment & Relations: https://www.hca.nm.gov/provider-enrollment-relations/

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