CO · guidance
CO HCPF Non-Emergent Medical Transportation (NEMT) Billing Manual — Payment for Covered Services
PaymentforCoveredServices
Paymentwillonlybemadefortheleastexpensivemodesuitabletothemember'scondition.
Providersinthestate-contractedbrokerserviceareamustbeenrolledinthebroker'snetworkinordertoprovideservicesandreceivepaymentforcoveredservices.ThebrokerpaysenrolledprovidersdirectlyforNEMTservices.ServicesprovidedinthebrokerserviceareaareonlyreimbursablebytheStateContractedBrokerandcannotbesubmitteddirectlytotheDepartment.
Reimbursementforservicesprovidedoutsidethestate-contractedbrokerserviceareashouldbesubmitteddirectlytotheDepartment.
RegardlessofwhetherHealthFirstColoradohasreimbursedtheprovider,billingmembersforcoveredservicesisstrictlyprohibited.Balancebillingisprohibited.Ifreimbursementismade,providersmustacceptthispaymentaspaymentinfull.RefertoProgramRule8.012.TheprovidermayonlybillthememberforservicesnotcoveredbyHealthFirstColorado.
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Provenance
- Source
- hcpf.colorado.gov
- Retrieved
- 2026-07-26
- Edition
- 2026-07-26
- Content hash
700e4fd853e81b3eb599b6e440158e166c6055a95d292ba2a54fcfcbdb6f20ad
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