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CO HCPF Non-Emergent Medical Transportation (NEMT) Billing Manual — Eligible Providers

EligibleProviders

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

ToprovideNEMTservicestoHealthFirstColoradomembersandreceivereimbursement,aprovidermusthaveeachoftheirdriversandvehiclescredentialed.ProvidersareprohibitedfromprovidingNEMTservicesusingdriversorvehiclesthatfailcredentialing.AllNEMTprovidersmustbecredentialedtoprovideHealthFirstColoradoservices.Thisincludesalldriversandvehicles.EffectiveJuly1,2026,MediDrivemanagesdriverandvehiclecredentialingforallNEMTprovidersstatewide.FailuretocompletethisprocesswillresultinfurtheractionbeingtakeninaccordancewithSection25.5-4-301,C.R.S.and10C.C.R.2505-10,Section8.076.

VisitProCredExloginorcreateanaccounttocompletethecredentialingrequirements..

ContactProCredexProviderSupportatSupport@procredex.comforsupportwiththecredentialingprocess.Important:Anynewdriversandvehiclesaddedtothebusiness,atanytime,mustbeapprovedbeforetheycanbeusedtotransportHealthFirstColoradomembers.Credentialsfornewdriversandvehiclesmustbesubmittedthroughthecredentialingsoftware.AnydriverorvehiclewhichfailscredentialingisprohibitedfrombeingusedtoprovideNEMTservicestoHealthFirstColoradomembers.VehicleInspectionsAllvehiclesmustbeinspectedregardlessoftheageofthecurrentinspection.EffectiveJuly1,2026,NEMTprovidersshouldcontactMediDrivetoscheduleavirtualvehicleinspectionexceptwhenthevehicleisinvolvedinanaccidentthenanin-personinspectionmustbecompleted.Thevehicleinspectionsarerequiredtocompletethecredentialingprocess.

Obtaintheappropriatelicense,certificate,orpermitfortheservicesyouwanttoprovide.Licensure,orproofofexemptionfromlicensurerequirements,mustbeincludedintheHealthFirstColoradoNEMTproviderapplication.Todeterminetheappropriatelicensure,contact:

Groundambulances:LicensingofgroundambulanceservicesareconductedbytheColoradoDepartmentofPublicHealthandEnvironment(CDPHE).ContacttheCDPHEforspecificambulancelicensingrequirementsand/orverificationofavalidlicense.

Airambulances:AirambulanceservicesareregulatedbythestatewhentheytransportpatientsoutofColorado.Ifyourairambulanceserviceagencywantstoprovidethisservice,itmustbeeitherlicensedorauthorizedbytheColoradoDepartmentofPublicHealthandEnvironment.

Allotherproviders:GainwellorCounty.

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AmbulanceprovidersmustcompleteaseparateenrollmentapplicationtobeeligibletoprovideEmergencyMedicalTransportationservices.

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ToprovideNon-MedicalTransportation(NMT)services,aseparateenrollmentapplicationisnecessarytosubmitclaimsforNMTservices.AprovidercannotbillNMTservicesthroughtheirNEMTProviderID.

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Theonlyexceptionstotheseproviderrequirementsarereimbursementsormileagepaidtomembers,members'family,members'friends,orvolunteersforcoveredservices,andcommercialair,train,andbustickets.LodgingprovidersarenotrequiredtoobtainPUCorambulancelicensurebutmustenrollasaHealthFirstColoradoNEMTproviderinordertosubmitclaimsforservices.

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Provenance

Source
hcpf.colorado.gov
Retrieved
2026-07-26
Edition
2026-07-26
Content hash
9980f31bd7c916b606aab910af8eb1d372ba97a867db5b709c345f602c6a3586
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