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CO HCPF Medical-Surgical Billing Manual — Vaccines/Immunizations

Vaccines/Immunizations

activein force · 2026-07-26 – presentas-observed

RefertotheImmunizationBenefitsBillingManuallocatedontheBillingManualswebpage.

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Bothmedicalcareandsurgeryareallowedwhenperformedonthesamedaybythephysicianwhenthesurgicalprocedureisminorinnature.Follow-upcarerequirementsaredeterminedbytheDepartmentofHealthCarePolicy&Financing(theDepartment)andarerelatedtothoseassignedbyMedicareandothersources.

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Newmembermedicalcarevisitsarelimitedtoone(1)permemberperprovider.AmedicalrecordsadministrativefeeisincludedinHealthFirstColoradoreimbursement.

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Nursingfacilityvisitsarelimitedtoone(1)visitperdaypermemberbythesameproviderforthesamediagnosisorcondition.

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Officevisitsarelimitedtoone(1)visitperdaypermemberbythesameproviderforthesamediagnosisorcondition.

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Providersmaybillfornon-routinesuppliesfollowingtheinstructionsinthecurrentCMSbulletinforpractitioners.

Billablenon-routinesuppliesarelistedintheCMSpublicationunderseparatecategories.ProvidersshouldalwaysrefertothemostcurrentpublicationswhenbillingHealthFirstColoradoassomesuppliesareconsideredinclusiveinthemedicalorsurgicalservice.

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Provenance

Source
hcpf.colorado.gov
Retrieved
2026-07-26
Edition
2026-07-26
Content hash
6a65d0407843c514a0d63bea2a281461a7a61e089eb5445a097ff335fb1b7859
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CO HCPF Medical-Surgical Billing Manual — Vaccines/Immunizations · binding.law