New Mexico Medicaid pays for in-home personal care and related services through 3 programs, including the Turquoise Care Agency-Based Community Benefit (ABCB) and the Turquoise Care Self-Directed Community Benefit (SDCB). The Community Benefit is provided through the four Turquoise Care MCOs (BCBS, Presbyterian, Molina, UnitedHealthcare) and is not available for 24-hour care. The HCA Developmental Disabilities Supports Division runs the DD Waiver; Mi Via (self-directed), Medically Fragile and Supports waivers also exist. Confirm with HCA whether personal care is also a separate state plan benefit outside the Community Benefit.
Which New Mexico waivers can a home care agency bill?
Each waiver below lists who it covers, the services it pays for, and how providers bill.
Turquoise Care Agency-Based Community Benefit (ABCB)
Population
Turquoise Care managed care members who meet nursing facility level of care and want to live at home; new members must start here for at least 120 days.
Services covered
personal care (consumer delegated or consumer directed)
respite
nursing respite
adult day health
home delivered meals
emergency response services
environmental modifications
private-duty nursing
skilled maintenance therapies
Billing format
Delivered by providers contracted with the member's MCO; EVV visits and claims run through AuthentiCare, which became an open/hybrid aggregator for MCO services on 2026-05-20.
To bill Medicaid for home care you need a state license, a Type 2 NPI, state Medicaid enrollment and screening, waiver or managed care contracts, EVV and authorizations.
Private pay means higher rates and fast payment; Medicaid means steady volume at state-set rates with authorizations and EVV. Compare rates, cash timing and admin before you mix them.
Track units remaining, the end date and the service code for every client, and check them before each schedule change. Hours over the cap are unbillable.
Four units equal one hour. How to convert units to hours, the common HCPCS codes, how states round partial units, and how to stay inside the authorization.
These free tools are made by the team behind Caregiver Scheduling,
caregiver scheduling software for home care agencies.
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