Heavy workers compensation and auto exposure, both of which are governed by state schedules rather than your commercial contracts. In New Mexico that plays out against a specific set of rules rather than a general one.
Claims for New Mexico providers are adjudicated by Novitas Solutions (JH), which is also who hears the first level of appeal — so an appeal argument that works here works in every state that contractor covers.
At a glance
Coding driver
Timed treatment codes, where unit calculation is systematic rather than occasional — an error repeats on every visit.
Medicare contractor
Novitas Solutions (JH)
Medicaid program
Turquoise Care
Auto injuries
Tort state — health plan sequencing applies
What changes in New Mexico
Medicaid in New Mexico runs as Turquoise Care and is delivered largely through commercial managed care plans, so most Medicaid claims are adjudicated by an insurer with its own filing window and its own authorization rules rather than by the state.
Where physical therapy claims fail
- Unit counts that do not match documented treatment time
- Visit caps reached without notice
- Provider did not re-certify the plan of care in time
We work the claims. You practice medicine.
Coding, claim submission, denial management, and A/R follow-up — with nothing left for your front desk to chase.
View pricingHow It Works
Review
We look at your New Mexico physical therapy denials.
Scope
A written scope and price before any work starts.
Transition
Coding and submission move across without a gap.
Report
Denial causes segmented by payer and provider.
Physical Therapy Billing in New Mexico — Frequently Asked Questions
Do physical therapy billing rules differ in New Mexico?
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Turquoise Care is delivered through commercial managed care plans, each setting its own filing window and authorization rules.
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