I/DD Waivers in New Mexico

All states: Medicaid disability services map

New Mexico I/DD services at a glance

Last verified against state sources: 2026-10-23.

Who runs I/DD services in New Mexico?

The New Mexico Health Care Authority (HCA) runs I/DD services. Inside HCA, the Developmental Disabilities Supports Division (DDSD) operates the I/DD waivers, and the Medical Assistance Division (MAD) is the state Medicaid agency. HCA is both the administering and the operating agency for the DD Waiver. DDSD used to sit in the Department of Health, and some older rules still use that name.

• Developmental Disabilities Supports Division (DDSD): runs the Developmental Disabilities (DD) Waiver, the Mi Via self-directed waiver and the Medically Fragile Waiver. It handles intake, the wait list, provider agreements and service standards.
• Medical Assistance Division (MAD): the Medicaid agency. MAD or its claims contractor pays waiver providers.
• Front door: the DDSD Pre-Service Intake Bureau, with regional Pre-Service Intake Specialists (505-350-0034 or 505-470-5825).
• Case management: in the DD Waiver, case management agencies with DDSD provider agreements build the Individual Service Plan (ISP) and budget. A case management agency may not provide any other DD Waiver service, and its staff may not have family or financial ties to the person's providers. In Mi Via, consultant agencies do this work. In the Medically Fragile Waiver, registered nurse case managers do it.
• Third Party Assessor: Comagine Health, the Medicaid Third Party Assessor, reviews level of care and prior authorizes budgets.

What Medicaid waivers and programs serve people with I/DD in New Mexico?

New Mexico has three 1915(c) waivers that serve people with I/DD: the DD Waiver, the Mi Via self-directed waiver and the Medically Fragile Waiver. A 1915(c) waiver is a federal Medicaid option that lets a state pay for home and community services instead of institutional care. All three are run by DDSD and paid fee-for-service. A fourth waiver, the Supports Waiver, ended on September 28, 2025.

• Developmental Disabilities (DD) Waiver (1915(c), CMS control number 0173): often called the traditional DD Waiver. It serves children and adults with an intellectual disability or a related developmental condition who meet ICF/IID level of care and Medicaid financial eligibility. Services include case management, Living Supports (Family Living, Supported Living and Intensive Medical Living Services), Customized In-Home Supports, Customized Community Supports, Community Integrated Employment, respite, adult nursing, therapies, behavior support consultation, crisis supports, assistive technology, remote personal support technology, environmental modifications and non-medical transportation. Living Supports and Customized In-Home Supports are for adults 18 and older; children under 18 can get a smaller set of services such as case management, respite and behavior support consultation. CMS approved a renewal for a new five-year cycle effective July 1, 2026, with 5,880 people projected in the first year, according to HCA's public comment responses.
• Mi Via Self-Directed Waiver (1915(c), control number 0448.R04.00): serves people of any age with intellectual or developmental disabilities, autism or medically fragile conditions who meet ICF/IID level of care. The person or an employer of record hires their own workers, with a financial management agency (Palco, working with Conduent) handling payroll. Services include consultant services, homemaker and direct support, in-home living supports, respite, community direct support, employment supports, therapies, nursing, and individual directed goods and services. It was renewed effective October 1, 2025 through September 30, 2030.
• Medically Fragile Waiver (1915(c), control number 0223.R07.00): serves people who have a developmental disability, delay or risk of delay plus a medically fragile condition diagnosed before age 22, and who meet ICF/IID level of care. Services include nurse case management, private duty nursing, home health aide, respite (14 days or 336 hours per budget year), therapies and specialized medical equipment.
• Supports Waiver (ended): CMS lists this waiver (1726) as terminated on September 28, 2025. It is no longer an option.

The institutional option is an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID), which a person can choose instead of waiver services when a slot is offered. HCA itself operates Los Lunas Community Programs, which people can choose as a DD Waiver provider for some services.

Does New Mexico pay for I/DD services through managed care?

No. DD Waiver and Mi Via services are paid fee-for-service. The DD Waiver rule says MAD or its claims processing contractor pays enrolled providers directly by electronic funds transfer. Case management agencies (DD Waiver) and consultants (Mi Via) plan and coordinate services, and the Third Party Assessor prior authorizes budgets.

New Mexico's Medicaid managed care program is called Turquoise Care. We did not find a state document saying whether waiver participants get their other Medicaid benefits through a Turquoise Care health plan while waiver services stay fee-for-service. People in an ICF/IID are excluded from managed care enrollment.

Is there a waiting list for I/DD services in New Mexico?

Yes. Eligible applicants are placed on the Central Registry wait list and offered services by application date when funding is available, with a faster process for emergencies. DDSD said it would send 245 allocation offers to people on the wait list as of July 7, 2025, starting monthly offers in August 2025. DDSD expected 50 to 60 offers a month after that.

• How offers work: under DDSD Numbered Memo 2025-09, monthly allocation offers began August 15, 2025.
• Count: the same memo's regional table of people waiting as of July 7, 2025 adds to 220 (Metro 98, Northeast 23, Northwest 29, Southeast 35, Southwest 35), most of them under 18. We did not find a newer count published by the state.
• While waiting: HCA's Allocation Process page says people may get limited State General Fund services or Turquoise Care Community Benefits.

For a person's place on the list, families can call the DDSD Pre-Service Intake Bureau.

How do people apply for I/DD services in New Mexico, and how are budgets set?

People apply through the DDSD Pre-Service Intake Bureau. DDSD decides whether the person has an intellectual disability or related condition, and the person must also meet ICF/IID level of care and Medicaid financial eligibility. For the DD Waiver, the Third Party Assessor now uses the Vineland Adaptive Behavior Scales to assess support needs.

• Eligibility: an intellectual disability (an IQ of about 70 or below with limits in daily living skills that began before age 18) or a related condition, ICF/IID level of care, and Medicaid financial eligibility through a Medicaid application to the Income Support Division. Level of care goes through the Third Party Assessor, using the Long Term Care Medical Assessment Abstract (MAD 378) and a history and physical.
• When a slot is offered: the person gets a Letter of Interest and a Primary Freedom of Choice form, chooses home and community services (DD Waiver or Mi Via) or an ICF/IID, and then picks a case management agency or a Mi Via consultant.
• Assessment: under DDSD Numbered Memo 2026-15, the Third Party Assessor completes a Vineland assessment in the home for initial allocations and each annual recertification, scheduled 90 days before the level of care expires. For levels of care expiring October 1, 2026 or later, case managers no longer send the MAD 378 to the assessor. The 2026 renewal also dropped the Person-Centered Assessment.
• DD Waiver budgets: the case manager builds the ISP and budget and sends it to the Third Party Assessor for prior authorization.
• Mi Via budgets: the consultant helps write the Service and Support Plan. The individual budget amount is set by age and level of care, and the Third Party Assessor reviews it.

What day and residential services can I/DD providers offer in New Mexico?

DD Waiver providers can offer Customized Community Supports (CCS) and Community Integrated Employment (CIE) as day services, and several Living Supports options as residential services. Agencies need a DDSD provider agreement and are surveyed by the Division of Health Improvement (DHI). We did not find a separate facility license for these services. From July 1, 2026, agencies no longer need CARF or CQL accreditation.

Day and employment services (DD Waiver)

• Customized Community Supports, Individual: one-to-one (1:1) skill building and community activities, in the community or remotely, never in a segregated work setting. We did not find a published billing unit.
• Customized Community Supports, Small Group: community activities in groups of three or fewer, in the community or remotely, and never in an agency-operated building. Billed in 15-minute units ($6.24 in the July 2026 renewal memo).
• Customized Community Supports, Group: group day services that may take place in an agency-operated building, in the community or remotely, in three categories by support need. Category 1 may not go above one staff to six people (1:6). Category 2 Extensive Support and Former Jackson Only may not go above 1:4. HCBS settings rules apply, and DDSD makes quality visits to provider-operated buildings. We did not find a published billing unit.
• Community Integrated Employment: supports for paid work in integrated settings, including job development, self-employment, intensive CIE, job maintenance and group CIE. Group Category 1 is up to 1:6 and Category 2 Extensive Support up to 1:4. Job maintenance is 1:1 and billed as a monthly unit built on 4 to 40 hours a month. We did not confirm billing units for the other parts. The July 2026 renewal removed CIE Job Aide and Community Inclusion Aide.

Residential and in-home services (DD Waiver)

• Supported Living: an agency-staffed home shared by two to four people, with up to 24/7 support. Paid as a daily rate in four categories by need, from $229.60 (Category 1) to $480.52 (Category 4) in the July 2026 renewal memo, with billable days capped at 340 per ISP year.
• Family Living: the person lives with family or a host family that gives support up to 24 hours a day, under contract with a Family Living agency. A home is limited to two people, with exceptions, and adult nursing services are required.
• Intensive Medical Living Services: a shared home with 24/7 agency staff, daily nursing visits, weekly registered nurse visits and nutritional counseling, for people who need daily skilled nursing.
• Customized In-Home Supports: support for adults living in their own home or with family or friends. Billed in 15-minute units ($8.73 in the July 2026 renewal memo) and requires electronic visit verification (EVV).

Details are in the DD Waiver service standards and DDSD Numbered Memo 2026-11 on the renewal.

How are I/DD provider rates set and how do agencies enroll in New Mexico?

DDSD sets waiver rates from independent rate studies, which state law requires every two years. Rates need CMS approval. The DD Waiver renewal approved effective July 1, 2026 carried limited rate increases funded by House Bill 2, signed March 11, 2026. Agencies enroll by applying to DDSD's Provider Enrollment and Relations Unit.

• Rate studies: House Bill 395 (2023) requires DDSD to study waiver rates every two years. The 2023 study, plus a 5.32 percent cost of living increase, raised rates an average of 16.5 percent in fiscal year 2025. Health Management Associates (Burns and Associates) ran the 2025 study. Its final report found the proposed rates would raise overall waiver spending by 16.1 percent if funded, and DDSD said it would not adopt the recommended cuts. See HCA's rate studies page.
• Latest rates: examples from the July 2026 renewal memo: Supported Living Category 1 went from $221.54 to $229.60 a day, Customized In-Home Supports from $8.42 to $8.73 per 15 minutes, and occupational and speech therapy to $49.66 per 15 minutes. We did not find the current DD Waiver rate table online.
• Enrollment: agencies submit the DD Waiver Qualified Provider Application to DDSD's Provider Enrollment and Relations Unit. The process takes about 90 days, and agencies must meet HCBS settings rules before approval. They then sign a provider agreement with liability insurance and a fidelity bond naming HCA. Medicaid enrollment itself is done through the YES.NM portal.
• EVV: the DD Waiver service standards require Customized In-Home Supports and Respite providers to use the state's EVV system, Fiserv AuthentiCare, and say services not captured in EVV without a state exception cannot be paid. Mi Via homemaker, in-home living supports and respite workers also clock in through AuthentiCare. Since September 30, 2025, fee-for-service agencies may use an approved third-party EVV system that sends data to AuthentiCare. Residential and day services are not EVV services.

What is changing next for I/DD services in New Mexico?

HCA has proposed a Mi Via waiver amendment that adds Support Broker Services. No effective date has been published. The proposal is not final until CMS approves it.

• Mi Via Support Broker Services: HCA Tribal Notification 26-16 (July 30, 2026) proposes adding Support Broker Services to Mi Via and renaming the employer of record role. Comments closed September 28, 2026. We did not find a date for submission to CMS or for the change to take effect.
• Rate study funding: the full rates proposed in the 2025 rate study depend on future funding from the legislature. Only limited increases were funded for the July 2026 renewal.

Recent changes already in place: the DD Waiver renewal took effect July 1, 2026, adding the Vineland, removing two services, dropping the accreditation requirement and raising some rates. The Supports Waiver ended September 28, 2025.

New Mexico I/DD sources

• New Mexico Health Care Authority: Developmental Disabilities Waiver
• New Mexico Health Care Authority: Allocation process resources
• DDSD Numbered Memo 2025-09 (monthly allocation offers)
• DDSD Numbered Memo 2026-11 (DD Waiver renewal effective July 1, 2026)
• DDSD Numbered Memo 2026-15 (Vineland assessment)
• DDSD: DD Waiver service standards
• CMS: New Mexico waiver factsheet
• 8.314.5 NMAC: Developmental Disabilities Home and Community-Based Services Waiver
• New Mexico Health Care Authority: Rate studies
• HCA Tribal Notification 26-16 (proposed Mi Via amendment)

Related reading

• Disability Services and Independent Living Guide
• Essential Acronyms in Disability Services: A Quick Reference Guide
• Disability Services DayHab has a dilemma - how to solve it
• Outcome Measures in Disability Services: Measuring what matters
• I/DD services in every state (map)
• New Mexico EVV requirements

Page history

• October 23, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for I/DD provider agencies, including EVV, service documentation, goal tracking and billing. If you would like to talk through your program, contact Ankota or read more about Ankota's I/DD software.