Access to Presbyterian Healthcare Services

For Emergency Services, call 911 or go to the nearest hospital, including any PHS Hospital. For non-emergency services, see below. 

Presbyterian Healthcare Services, or “PHS,” has providers in several communities in New Mexico. We call these providers “PHS Providers.” To determine if a PHS Provider is a Participating Provider, New Mexico is divided into two geographical areas:

1. The four counties of Bernalillo, Sandoval, Torrance and Valencia that we call “Metro Counties;” and
2. All other counties in New Mexico that we call “Regional Counties.”

To determine if a PHS Provider is a Participating Provider or a Non-Participating Provider for you, there are three options: 

1. Contact Blue Cross and Blue Shield of New Mexico Customer Service at the number listed on the back of your BCBSNM health insurance card. Non-members can call Customer Service at 1-800-835-8699.
2. Refer to our online provider directory under the Find Care tab, Providers in Your Network, and click Find a Doctor or Hospital. Federal Employee Program members should refer to the online FEP provider directory at provider.fepblue.org; or
3. Find the three-letter network identifier on the front of your member ID card. Learn where to find your network identifier.

Using the network identifier on your ID card and the information below, you can determine if a particular PHS Provider is a Participating Provider for you in most situations. 

If the network identifier on your ID card shows HMO, PPO, NLP, BAV, CNN or FEP (including FEP Blue Focus, Standard Option or Basic Option), then follow the table below to determine if a PHS Provider is a Participating Provider for you:

*The exception to this rule is that the providers of the following services are Participating Providers: transplants, neurology, neurosurgery, pediatric endocrinology, pediatric heart surgery, pediatric neurology, pediatric pulmonology, pediatric ear-nose-throat, pediatric gastroenterology, pediatric hematology/oncology or neonatal intensive care, urgent care centers including PRESNow locations, MRIs at the Presbyterian MRI Center and facility services at Presbyterian Rust Medical Center ASC and New Mexico Surgery Center Mutli-Specialty.

**The exception to this rule is that the providers of the following services are Non-Participating Providers: primary care.

If the network identifier on your ID card shows MCD, Medicare Advantage HMO, then PHS Providers in the Metro Counties are Non-Participating Providers* and PHS Providers in the Regional Counties are Participating Providers.

*The exception to this rule is that the providers of the following services are Participating Providers: facility services at Presbyterian Rust Medical Center ASC and New Mexico Surgery Center Mutli-Specialty.

If the network identifier on your ID card shows NBP, follow the table below to determine if a PHS Provider is a Tier 1 Participating Provider, Tier 2 Participating Provider or Non-Participating Provider.

*The exception to this rule is that the providers of the following service(s) are Tier 1 Participating Providers: transplants, neurology, neurosurgery, pediatric endocrinology, pediatric heart surgery, pediatric neurology, pediatric pulmonology, pediatric ear-nose-throat, pediatric gastroenterology, pediatric hematology/oncology or neonatal intensive care, urgent care centers including PRESNow locations, MRIs at the Presbyterian MRI Center and facility services at Presbyterian Rust Medical Center ASC and New Mexico Surgery Center Mutli-Specialty.

**The exception to this rule is that the providers of the following service(s) are Non-Participating Providers: primary care.

If the network identifier on your ID card shows Medicare Advantage PPO, then all PHS providers are in network; this includes providers in both the Metro Counties and the Regional Counties.

If you have any questions, contact your Customer Service Representative at the number on your ID card. Non-members can call Customer Service at 1-800-835-8699.