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New Mexico Medicaid Prior Authorization Form

New Mexico Medicaid Prior Authorization Form

Updated July 27, 2023

A New Mexico Medicaid prior authorization form is a document used by medical professionals to request Medicaid coverage for a non-preferred drug. It’s necessary to provide medical justification for not using a drug from the State-approved Preferred Drug List. Once the form is complete, it needs to be faxed to the correct directory. A downloadable PDF version of the New Mexico Medicaid Prior Authorization Form is available here.

Preferred Drug List