On November 7, 2025, the New Mexico Workers’ Compensation Administration (WCA) updated its Payments for Health Care Services rules, which govern the Health Care Provider Fee Schedule.

While no immediate implementation is required, the rule now permits use of any Explanation of Benefits (EOB) codes listed in the fee schedule. The update was made to add CARC (Claim Adjustment Reason Codes) and RARC (Remittance Advice Remark Codes) codes to the fee schedule effective January 1, 2026.

These codes explain why a claim was denied or paid differently than billed and provide additional adjustment details. Once the fee schedule updates take effect, payers may use CARC, RARC or NM specific EOB codes 01–23 to dispute a bill. Currently, only codes EOB-01 through EOB-23 are allowed for this purpose.

This shift can help to streamline claim adjudication by leveraging nationally recognized codes that are consistently applied. Expanding beyond state-specific codes to include CARC and RARC enhances transparency and compliance by providing a broader set of standardized options for reporting bill adjustments and remarks.