We provide behavioral health care coverage for many Blue Cross and Blue Shield of New Mexico members. Coverage varies according to the member’s benefit plan.
Check eligibility and benefits: Use Availity® Essentials or your preferred vendor to verify membership and coverage details for every visit.
Behavioral health care management is integrated with our medical care management program. The program helps members access their behavioral health benefits and improves coordination of care between medical and behavioral health providers.
This integration helps our clinical staff identify members who could benefit from coordination between their medical and behavioral health care and may result in:
- Improved outcomes
- Enhanced continuity of care
- Greater clinical efficiencies
- Reduced costs over time
We may refer some members* to other programs designed to help identify and close potential gaps in care.
Blue Cross Community CentennialSM behavioral health services are managed by BCBSNM for all members who have BCBSNM Community Centennial medical benefits.
Federal Employee Program® members are managed by BCBSNM. FEP members are not required to request prior authorization for any outpatient behavioral health services, including Partial Hospitalization programs.
All behavioral health benefits are subject to the terms and conditions of the member's benefit plan.
* We may refer members experiencing inpatient hospitalization, complex or special health care needs or who are at risk for medical complications to medical care management programs through a variety of mechanisms such as predictive modeling, claim utilization, inbound calls, self-referrals and physician referrals. If members do not have medical care management programs as part of their group health plans, they will not be referred to other medical care management programs.