New Mexico Statutes 59A-23-28. Level of care determinations for the provision of mental health or substance use disorder services
A. An insurer shall provide coverage for all in-network mental health or substance use disorder services, consistent with generally recognized standards of care, including placing an insured into a medically necessary level of care.
B. Changes in level and duration of care shall be determined by the insured’s provider in consultation with the insurer.
C. Level of care determinations shall include placement of an insured into a facility that provides detoxification services, a hospital, an inpatient rehabilitation treatment facility or an outpatient treatment program.
D. Level of care services for an insured with a mental health or substance use disorder shall be based on the mental health or substance use disorder needs of the insured rather than arbitrary time limits.