CO · guidance
CO HCPF Private Duty Nursing Billing Manual — Provider Qualifications
ProviderQualifications
ProvidersmustbeenrolledasaHealthFirstColoradoproviderinorderto:
TreataHealthFirstColoradomember
SubmitclaimsforpaymenttoHealthFirstColorado
InordertobecomeaHealthFirstColoradoHomeHealthProvider,anagencymust:
HoldacurrentandactiveClassAHomeCareLicenseissuedbytheStateofColorado
ObtainMedicarecertificationand/ordeemedstatuswithanacceptedHomeHealthAccreditationentity:JointCommission(JC),CommunityHealthAccreditationProgram(CHAP)ortheAccreditationCommissionforHealthCare,Inc.(ACHC)
BeenrolledasaMedicareprovider
BeingoodstandingwiththeDepartment,ColoradoDepartmentofPublicHealthandEnvironment(CDPHE)andMedicare
PriortobecomingaHealthFirstColoradoHomeHealthprovider,enrollingagenciesmustfirstobtainlicensureandcertificationasaClassAHomeCareAgency,followingallprocessesrequiredbyCDPHE.OncelicensedandcertifiedasaClassAHomeCareAgency,applicantsmustsubmitacompletedproviderenrollmentpackettobecomeHealthFirstColorado-eligibleproviders.VisittheProviderEnrollmentwebpageandtheRevalidationwebpageforenrollmentinformation.
AllPrivateDutyNursingservicesaresubjecttopost-paymentreviewformedicalnecessityandregulationcompliance.
ProvidersshouldrefertotheCodeofColoradoRegulations,ProgramRules(10C.C.R.2505-10Section8.540),forspecificinformationwhenprovidingPDNservices.
BacktoTop
Provenance
- Source
- hcpf.colorado.gov
- Retrieved
- 2026-07-26
- Edition
- 2026-07-26
- Content hash
906633de71276413e21b972d19d969e1c4f85d94d48043c735905c16b34410dc
The link goes to the issuing authority’s own document — the one we read to produce this record. Where a source publishes whole titles rather than sections, your browser may need a moment to jump to the provision.
Unofficial copy of government-published law, reproduced from official sources with full provenance. Not an official publication; verify against official sources before relying on it in a filing. Records in the 'guidance' corpus, and only that corpus, are sub-regulatory (interpretive guidelines, survey procedures) and are not binding law. Validity bounds follow each jurisdiction's declared temporalBasis.