CO · guidance
CO HCPF Community First Choice (CFC) Billing Manual — General Information
GeneralInformation
Asoftheprogram’seffectivedateofJuly1,2025,CommunityFirstChoice(CFC)providesselectHomeandCommunityBasedServices(HCBS)andservicedeliveryoptionstoHealthFirstColorado(Colorado'sMedicaidprogram)StatePlanMemberswhomeettheeligibilitycriteria.ReceiptofCFCservicesdoesnotprecludemembersfromreceivingservicesacrossotherHealthFirstColoradoprogramsand/orauthorities,suchasHCBSwaiverprograms.MembersmayreceiveHCBSservicesonone(1)HCBSWaiverconcurrenttoCFC,aslongasservicesarenotduplicative.Suchmembersmustmeetallrequiredtargetingcriteriaforeachwaiverinordertobeeligible,aswellasthereceiptofone(1)monthlywaiverservice.
CFCdoesnotcreateaneweligibilitycategoryunderHealthFirstColoradoanddoesnotincreasethefinancialeligibilitythresholdforMembersseekingLong-TermCare.TobefinanciallyeligibleforCFC,membersmusteitherbeeligibleforHealthFirstColoradooranHCBSwaiver,receivingatleastone(1)waiverservicepermonth,andmeetaninstitutionallevelofcare(LOC)asdeterminedbyaCaseManagementAgency(CMA).LevelofcaredeterminationsaremadeannuallybytheCMAusingthestateprescribedLevelofCareassessment.
CFCservicesareavailabletoMembersofallagesandarenotbasedondisabilityordiagnosis.ThereceiptofCFCservicesisnotpermittedininstitutionalsettingssuchasnursingfacilitiesorlong-termhospitals.WhenaMemberchoosestoreceiveservicesunderCFC,theservicesmustbeprovidedbycertifiedHealthFirstColoradoproviders.
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Provenance
- Source
- hcpf.colorado.gov
- Retrieved
- 2026-07-26
- Edition
- 2026-07-26
- Content hash
0f816d66e8e9777295d0192152e1fa95949b5c7b64514a7692c79dfac24b5727
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