CO · guidance
CO HCPF Dialysis Billing Manual — Dialysis
Dialysis
ProvidersmustbeenrolledasaHealthFirstColorado(Colorado'sMedicaidprogram)providerinorderto:
TreataHealthFirstColoradomember
SubmitclaimsforpaymenttoHealthFirstColorado
HealthFirstColoradoprovideshemodialysisandperitonealdialysisbenefitstoeligiblemembersinoutpatient,state-approvedfreestandingdialysistreatmentcentersandthehomesetting.TheseservicesarebilledontheUB-04institutionalpaperclaimformorasan837Institutional(837I)electronictransaction.
State-approvednon-routineservicesprovidedoutsideoftheroutinedialysistreatmentshouldbebilledandreimbursedseparately.TheservicesmustbebilledontheCMS1500professionalpaperclaimformorasan837Professional(837P)electronictransactionusingthedialysiscenterNationalProviderIdentifier(NPI)number.
ProvidersshouldrefertotheCodeofColoradoRegulations,ProgramRules(10C.C.R.2505-108.310),forspecificinformationwhenprovidingdialysisservices.
Dialysismaybeprovidedaspartofinpatienthospitaltreatmentandincludedinthehospitalinpatientclaim.RefertotheDialysisBenefitssectionbelow.
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Provenance
- Source
- hcpf.colorado.gov
- Retrieved
- 2026-07-26
- Edition
- 2026-07-26
- Content hash
c738b15652546d53a6bac63e8514ddc6975886f8f0e7fbfc59fa0cd608f45dcd
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