Reinforce Prenatal and Postpartum Care to Support Whole Health

We track quality measures related to our members’ care visits and depression screening during and after pregnancy. Review tips to close gaps in care.

Register for Critical Incident Reporting Training

The webinar for behavioral health providers fulfills an annual requirement for Turquoise Care. See training dates and how to register to receive credit.

Behavioral Health Documentation to Be Reviewed for Turquoise Care Members

Medical record documentation standards help ensure quality care. Learn what information may be requested or reviewed through electronic health records.

Take Note of Prior Authorization Changes for Commercial and Government Programs

Effective July 1, 2025, prior authorization requirements for certain plans are changing to reflect new, replaced or removed codes. Learn about the changes for:

• Commercial

• Medicare Advantage

• Turquoise Care

Explore Learning Opportunities

We offer free training for providers who participate in our networks. Sign up for sessions, including coding webinars that offer continuing education units.

National Drug Code Fee Schedule to Be Updated

Effective June 1, 2025, reimbursement rates for some medications may change. Review how to request a copy of the changes.

Reimbursement Parity for Certain Pharmaceutical Services Covered Under Turquoise Care

Certain services provided by pharmacy providers will now be reimbursed at the same rate as other medical providers.

Pharmacy Program Quarterly Update – Part 2

Changes were made to our drug lists and utilization management program. Learn about these and other pharmacy program updates.

Learn about Updates to Clinical Payment and Coding Policies

We regularly add and modify our CPCPs as part of our ongoing policy review. See which policies were updated and when.

Take Note of Provider Reference Manual Updates

Our Provider Reference Manual is updated, effective March 24, 2025. Changes to the manual include, but aren’t limited to, the following section: 15 – Provider Service Inquiry and Grievance Process. Please review it for all changes.

Review Medical Policy Updates

Approved new or revised medical policies and their effective dates are usually posted on our website the first and 15th of each month. You can view all active and pending policies, as well as draft medical policies, and provide comments on draft policies. These policies may impact your reimbursement and your patients’ benefits.

Review Appointment Availability Standards for Turquoise Care Members

To help ensure Medicaid members have timely access to care, required appointment scheduling time frames have been established for certain services.

Learn About Contracting with Turquoise Care

If you’re interested in becoming a provider of Turquoise Care, call 505‑837‑8800 or 800‑567‑8540. Providers participating in our commercial products are not automatically participating providers in Turquoise Care.

Celebrate Women’s Health at our Blue Door Neighborhood Center^SM

You and your patients are invited to attend our May 10, 2025, event in Albuquerque. It includes on‑site mammogram scheduling and health screenings at no cost.