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CO HCPF Physician-Administered Drugs (PAD) Billing Manual — PAD Revisions Log

PADRevisionsLog

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

RevisionDate

Additions/Changes

Madeby

5/4/2020

Manualcreated

HCPF

5/8/2020

ConvertedtoHTML

HCPF

6/1/2020

PADresourcepagelinkandFAQs#13added.

HCPF

8/03/2020

Tableofcontents,NewDrugs,andWastedDrugupdated,RetentionofRecords,AcceptableUse,andExclusionsadded,PharmacyBillingRequirement-Exceptionssectionupdated,EAPGcarve-outchangedtoOutpatientHospitalSpecialtyDrugcarve-out,FAQ#4updated.

HCPF

8/12/2020

Inpatient/OutpatientBillingManualadded,DurableMedicalEquipment,Prosthetics,OrthoticsandSuppliesBillingManualadded,HCPF_Colorado.SMAC@state.co.usupdated.

HCPF

8/21/2020

Updatedemailaddress

HCPF

9/16/2021

UpdatedemailaddresstoHCPF_PAD@state.co.us

HCPF

01/18/2022

UpdatedtheTableofContents,HCPCS/NDCCrosswalkandExclusionssections,PaymentMethodologysection,PharmacyBillingRequirementsandExceptionssections,PADPriorAuthorizationRequirementssection,andadded340BsectionandTemporaryCOVID-19PolicyandBillingInformation.UpdatedFAQs#2,4,8,10,11,and#13;added#12,14,and16.

HCPF

06/21/2022

UpdatedtheTableofContents,HCPCS/NDCCrosswalkadditionrequestsaddedtoHCPCS/NDCCrosswalksection,andFamilyPlanningExpansionaddedtoClaimSubmissionRequirementssection.

HCPF

9/1/2022

UpdatedtheTableofContents,addedPADPAadditionalinformation(OPspecialtydrugpolicy,unitsrequestedonthePA,retroactivePARs,andPAsubmission),addedCoordinationofBenefitssection,addedsectiontitleOtherMethodologiesunderPaymentMethodologiessection,addedDMEPOSsectionunderPharmacyBillingRequirements.

HCPF

10/14/2022

RemovedPhoneNumberReferencesandchangedGainwellTechnologiesmentionstoahyperlinkofProviderServicesCallCenter

HCPF

2/23/2023

AddedNoCOVID-19monoclonalantibodyEUAsintheUnitedStatesandminoredits

HCPF

4/11/2023

UpdatedURLs

HCPF

12/19/2023

TableofContents,RetentionofRecords,HCPCS/NDCCrosswalk,Exclusions,PADPriorAuthorizationInformation,UnitsRequestedonthePA,RetroactivePARs,OtherTPL,HospitalSpecialtyDrugPolicy,PaymentMethodologies,OtherMethodologies,WastedDrug,ClaimSubmissionRequirements,FamilyPlanningExpansion,andPADFAQs#2,4,6,7,8,10,13,and14updated.DuplicateReimbursementPaymentsandOpioidTreatmentProviders:Take-HomeBuprenorphinesectionsadded.

HCPF

3/1/2024

TableofContents,RecordKeepingandRetention

HCPF

7/28/2025

UpdatedHospitalSpecialtyDrugsectionandremovedTemporaryCOVID-19PolicyandBillingInformationsection

HCPF

07/20/2026

AddedProgramIntegrityandCompliancesection

HCPF

Backtotop

Provenance

Source
hcpf.colorado.gov
Retrieved
2026-07-26
Edition
2026-07-26
Content hash
715bd04a756b7f7eedefd5a1a458e93ece9cd5f860f123fd6d75a62ea824ad9b
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