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CO HCPF Non-Emergent Medical Transportation (NEMT) Billing Manual — Benefit Overview

BenefitOverview

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

Non-emergentmedicaltransportation(NEMT)istransportationtoandfrommedicallynecessaryservicescoveredbyHealthFirstColorado(Colorado'sMedicaidprogram)formemberswhohavenoothermeansoftransportation,includingfreetransportation.NEMTcanonlybeutilizedtoaccessnon-emergencyservices.

NEMTcanonlybeutilizedtotransporteligiblememberstoandfromHealthFirstColoradoproviderservicelocationsthatareenrolledtoprovidetheservicethememberistransportedtoreceive.RefertotheFindaDoctortooltodetermineifaproviderorservicelocationisanapprovedHealthFirstColoradoprovider.NEMTmustbeusedtoaccesstheclosestqualifiedHealthFirstColoradoproviderwillingandabletotreatthemember.NEMTcanonlybeusedtoaccessnon-emergencyservices.TransportationtoreceiveHomeandCommunityBasedServices(HCBS)mustbeprovidedthroughNon-MedicalTransportation(NMT).

ProvidersmustbeenrolledasaHealthFirstColoradoproviderinorderto:

ProvideNEMTservicestoaHealthFirstColoradomember

SubmitclaimsforpaymenttoHealthFirstColorado

ProvidersshouldrefertotheCodeofColoradoRegulations(CCR),ProgramRules(10CCR2505-10),forspecificinformationwhenprovidingNEMTservices.

NEMTRegulationscanbefoundin10CCR2505-108.014.

EmergencyMedicalTransportation(EMT)regulationsallowinter-facilitytransfersbetweenhospitalstobebilledasEMTservices.Thesetransferscanincludetransportationofpeoplewhoareexperiencingamentalhealthorsubstanceusedisordercrisis.

9-1-1responsecallsarenotNEMT.Iftransportationisprovidedtothememberinresponsetoa9-1-1call,andtheservicemeetstherequirementsofEMT,theservicemaybebilledasEMTservices.

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Provenance

Source: hcpf.colorado.gov
Retrieved: 2026-07-26
Edition: 2026-07-26
Content hash: 1c40169d540de6fc59b571cd4a59b1f7eabdcdf90895389e6e58915d61a6dcf5

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