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CO HCPF Non-Emergent Medical Transportation (NEMT) Billing Manual — Procedure Coding
ProcedureCoding
HealthFirstColoradousestheCentersforMedicare&MedicaidServices(CMS)HealthcareCommonProceduralCodingSystem(HCPCS).ThecodesareusedforsubmittingclaimsforservicesprovidedtoHealthFirstColoradomembersandrepresentservicesthatmaybeprovidedbyenrolled,certifiedHealthFirstColoradoproviders.
HCPCSareusedtoidentifyandreimbursenon-emergentmedicaltransportationservices.
TheDepartmentupdatesandrevisesHCPCScodesthroughHealthFirstColoradobillingmanuals.
Theseriesoflocalprocedurecodesusedtobillformobilityvanservices(X6022-X6030)arenolongeravailable.ProvidersshoulduseHCPCSA0120plusmodifierTK(Extramemberorpassenger)tobillformobilityvanservices.Usetheappropriatenumberofunitstoidentifytheactualnumberofriders.
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Whenbillingforonemembertakingmultipletripsinthesamedaywiththesamerenderingprovider,modifier76mustbeused.Whenbillingforonemembertakingmultipletripsinthesamedaywithdifferentrenderingproviders,modifier77mustbeused.
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ProcedureCode
Mod-1
Mod-2
Mod-3
Unit
Description
A0110
TN
Ticket,One-Way
FixedRoute,One-Way,Local
A0110
SC
SE
TN
Ticket,One-Way
FixedRoute,One-Way,Regional
A0110
SE
Ticket,One-Way
Paratransit,One-Way
A0110
Ticket,One-Way
Public/MassTransportation,BusService
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Code
Unit
Description
A0080
Mile
VolunteerVehicleMileage-vehicleprovidedbyvolunteer(individualororganization),withnovestedinterest
A0090
Mile
IndividualVehicleMileage-vehicleprovidedbyindividual(familymember,self,neighbor)withvestedinterest
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Code
Unit
Description
NOTES
A0120
OneWayTrip
Mobility/AmbulatoryVehicles
A0425
Mile
Groundmileage,perstatutemile
Onlyusedforbillingtripswithadateofserviceon/beforeJune30,2025
S0215
Mile
Groundmileage,perstatutemile
Onlyusedforbillingtripswithadateofserviceon/afterJuly1,2025
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Code
Unit
Description
A0130
OneWayTrip
WheelchairVan
S0209
Mile
WheelchairVanMileage
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Code
Unit
Description
NOTES
A0100
OneWayTrip
Taxi
Onlyusedforbillingeachlegofthetrip.1unitofservice=1legofthetrip.Forexample,aroundtriptoadestinationandbackwouldhave2unitsofservicebilled.
A0425
Mile
Groundmileage,perstatutemile
OnlyusedforbillingtripswithadateofservicebetweenJuly1,2024andJune30,2025
S0215
Mile
Groundmileage,perstatutemile
Onlyusedforbillingtripswithadateofserviceon/afterJuly1,2025
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Code
Unit
Description
T2005
OneWayTrip
Stretchervan
T2049
Mile
StretcherVanMileage
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Code
Unit
Description
A0428
OneWayTrip
Nonemergencytransportation:Ambulanceservice-BasicLifeSupport(BLS)
A0426
OneWayTrip
Nonemergencytransportation:Ambulanceservice-AdvancedLifeSupport(ALS),level1
A0433
OneWayTrip
Ambulanceservice-AdvancedLifeSupport(ALS),level2
A0434
OneWayTrip
Specialtycaretransport(SCT).DiscontinuedfromNEMTbenefiteffective11-1-2025.
A0425
Mile
Groundmileage,perstatutemile
A0021
Mile
Ambulanceservice,outsidestatepermile,transport
A0422
PerUnit
Ambulance(ALSorBLS)oxygenandoxygensupplies,lifesustainingsituation
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Code
Unit
Description
A0430
OneWayTrip
Ambulanceservice,conventionalairservices,transport,oneway(fixedwing)
A0431
OneWayTrip
Ambulanceservice,conventionalairservices,transport,oneway(rotarywing)
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Code
Unit
Description
A0140
PerTrip
Trainand/orAir
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Code
Unit
UnitLimit
Description
T2001
OneWayTrip
N/A
EscortTransportation
A0180
PerDiem
1perday
TravelLodgingforMember
A0190
PerDiem
1perday
TravelMealsforMember
A0200
PerDiem
1perday,perescort
TravelLodgingforEscort
A0210
PerDiem
1perday,perescort
TravelMealsforEscort
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Provenance
- Source
- hcpf.colorado.gov
- Retrieved
- 2026-07-26
- Edition
- 2026-07-26
- Content hash
782a0db48168e14acb8ada214da42c7145c386771e1640383716fd5832495ba3
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