N.M. Code R. § 8.308.9.13 - SPECIFIC CASE MANAGEMENT PROGRAMS
The benefit package includes case management services necessary to meet an identified service need of a member. The following are specific case management programs available when a member meets the requirements of a specific service.
A.
Case management services for adults with developmental
disabilities: Case management services are provided to a member 21 years
of age and older who is developmentally disabled as detailed in 8.326.2
NMAC.
B.
Case management
services for pregnant individuals and their infants: Case management
services are provided to a member who is pregnant up to 60 calendar days
following the end of the month of the delivery as detailed in 8.326.3
NMAC.
C.
Case management
services for traumatically brain injured adults: Case management
services are provided to a member 21 years of age and older who is
traumatically brain injured as detailed in 8.326.5 NMAC.
D.
Case management services for
children up to the age of three: Case management services for a member
up to the age of three years who is medically at-risk due to family conditions
and who does not have a developmental delay as detailed in 8.326.6
NMAC.
E.
Case management
services for the medically at risk (EPSDT): Case management services for
a member under 21 years of age who is medically at-risk for a physical or
behavioral health condition as detailed in 8.320.2 NMAC.
Notes
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