CO · guidance
CO HCPF Lactation Support Services Billing Manual — Program Overview
ProgramOverview
OnDecember1,2024,theColoradoDepartmentofHealthCarePolicyandFinancing(theDepartment)implementedaLactationSupportServicesbenefitforHealthFirstColoradomembers.ThisprogramisbasedonlegislationHB22-1289.
RulesandRegulationsTheLactationSupportServicesbenefitprogramisadministeredbytheDepartment.RulesgoverningtheprogramareoutlinedintheCodeofColoradoRegulations10C.C.R.2505-108.732.7.ProvidersarerequiredtocomplywithallrulesandguidanceprovidedbytheDepartmentandareencouragedtocontacttheDepartment’spolicyspecialistswithanyquestionsatHCPF_MaternalChildHealth@state.co.us.Updatestopolicyandguidancewillbepublishedinthismanual.ProviderswillbegivennoticeofupdatesthroughtheDepartment’smonthlyProviderBulletin.ThisprogramgivespeopleaccesstoLactationSupportServices,includingtrainingandcounselingthebreastfeeding(orlactating)memberaboutbreastfeedingandhumanlactation.Itprovidescomprehensive,skilledcareandevidence-basedinformationforbreastfeedingandhumanlactation.Tobeeligiblefortheprogram,amembermustmeetthefollowingcriteria:
BeeligibleforHealthFirstColorado
Beapregnant,postpartumorpediatricmemberwhoisbreastfeeding
MemberEligibilityBeforerenderingservices,theprovidershouldverifythemember'seligibilitytoensurethatthememberiseligibleforbenefits.Providersshouldretaindocumentationoftheverifiedeligibilityforbillingpurposes.InordertobeeligibleforreimbursementforservicesprovidedtoChildHealthPlanPlus(CHP+)members,allCHP+providersmusthaveanactivecontractwithaCHP+ManagedCareOrganization(MCO)andmaintaincurrentenrollmentinHealthFirstColorado.ProvidersshouldsubmitclaimstotheMCOonceaCHP+memberisenrolledintoanMCO.RefertotheChildHealthPlanPlus(CHP+)webpageforfurtherguidance.BacktoTop
Provenance
- Source
- hcpf.colorado.gov
- Retrieved
- 2026-07-26
- Edition
- 2026-07-26
- Content hash
f625778af0639c765cde8e86fbd372aa7ddf269549ae6a5bcc81447bf8eb6e30
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