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Insurance & Coverage Guide

New Mexico Medicaid Autism Coverage

New Mexico Medicaid (Turquoise Care) covers ABA under EPSDT for children under 21. The DD Waiver has one of the longest waiting lists in the country; Mi Via is the self-directed option, and Supports / Medically Fragile waivers are alternative paths. NM does not operate a traditional Katie Beckett program.

Quick Answer

New Mexico Medicaid (Turquoise Care) covers ABA under EPSDT for children under 21. The DD Waiver has one of the longest waiting lists in the country; Mi Via is the self-directed option, and Supports / Medically Fragile waivers are alternative paths. NM does not operate a traditional Katie Beckett program.

  • ABA benefit: covered under EPSDT for under 21 (via epsdt).
  • HCBS waivers: 4 relevant waiver options listed on this page.
  • Commercial insurance: New Mexico has a state autism insurance mandate.

Medicaid ABA Coverage

Yes — EPSDT

Under 21 (via EPSDT)

Insurance Mandate

Yes

HCBS Waivers

4 available

Waitlist: Long waitlist (multiple years)

Editorial Review

This page summarizes public Medicaid, waiver, and insurance-mandate information reviewed by the Autism Hearts editorial team.

Medicaid benefits, managed-care rules, and waiver waitlists can change quickly, so families should verify eligibility, prior authorization, and enrollment steps with the administering agency before relying on this page.

Last reviewed 2026-04-21 by Autism Hearts Editorial Team

New Mexico Commercial Insurance Mandate

Statute
New Mexico autism insurance mandate (NMSA 59A autism coverage provisions)
Age limit
Through age 19 (per statute; confirm with plan)

Covered services

Applied Behavior AnalysisSpeech therapyOccupational therapyDiagnostic services

Self-funded employer plans (often from large employers) are regulated by federal ERISA law, not state mandates, and may be exempt. Always confirm your plan type on your Summary of Benefits and Coverage.

Medicaid ABA Therapy Benefit

Covers ABA
Yes
Age limit
Under 21 (via EPSDT)
Prior auth required
Yes

NM Medicaid operates under Turquoise Care (successor to Centennial Care) as of 2024. ABA requires prior authorization through the child's Turquoise Care MCO.

New Mexico HCBS Waivers

Developmental Disabilities Waiver (DDW)

Covers autism

Individuals with IDD, all ages

Waitlist:Long waitlist (multiple years)
Apply via:DOH DDSD (register on Central Registry)

Mi Via Self-Directed Waiver

Covers autism

Waiver-eligible participants who want budget authority

Apply via:DOH DDSD

Medically Fragile Waiver (MFW)

Covers autism

Children and young adults with medical complexity and IDD

Apply via:DOH DDSD

Supports Waiver

Covers autism

Individuals with IDD needing lower-intensity supports (dollar-capped)

Apply via:DOH DDSD

Katie Beckett / TEFRA Option

Not available

New Mexico does not operate a traditional Katie Beckett / TEFRA option. Middle-income families typically rely on waiver eligibility (DDW, Supports, or Medically Fragile), which uses the child's own income/resources.

Early Intervention (Birth–3)

Family Infant Toddler (FIT) ProgramNew Mexico's IDEA Part C program. Children under 3 with developmental delays can access services without a formal autism diagnosis.

Official Sources

Use these primary sources when you need to confirm current Medicaid rules, waiver access, or state-agency guidance in New Mexico.