Billing Manuals by Provider Type
Refer to the table to determine which billing manual is used based on provider type.
| Provider Type | Type Descriptions | Training | Billing Manuals |
|---|---|---|---|
| 01 | Hospital - General | Institutional | Inpatient/Outpatient (IP/OP) Billing Manual |
| 02 | Hospital - Mental | Institutional | Inpatient/Outpatient (IP/OP) Billing Manual |
| 04 |
| Professional | DentaQuest Colorado Medicaid Dental Program Provider Office Reference Manual (ORM) |
| 05 | Physician | Professional | |
| 06 | Podiatrist | Professional | Medical-Surgical Billing Manual |
| 07 | Optometrist | Professional | Vision Care and Eyewear Manual |
| 08 | Optical Outlet | Professional | Vision Care and Eyewear Manual |
| 09 |
| Professional | |
| 10 | Home Health | Institutional | |
| 11 |
| Professional | Targeted Case Management-Transition Coordination |
| 12 | Independent Laboratory | Professional | Laboratory Services Billing Manual |
| 13 |
| Professional | |
| 14 |
| Professional | Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Billing Manual |
| 16 | Clinic - Practitioner | Professional | |
| 17 | Physical Therapist | Professional | Physical and Occupational Therapy Billing Manual |
| 18 | Chiropractor - Qualified Medicare Beneficiary (QMB) Benefits Only | Professional | Medical-Surgical Billing Manual |
| 19 | Audiologist | Professional | Audiology Benefit Billing and Policy Manual |
| 20 |
| Institutional | |
| 21 |
| Institutional | |
| 22 | Nurse - Midwife | Professional | Obstetrical Care Billing Manual |
| 23 | Program of All-Inclusive Care for the Elderly (PACE) | Professional | Program of All-Inclusive Care for the Elderly (PACE) Manual |
| 24 | Non-Physician Practitioner - Individual | Professional | Medical-Surgical Billing Manual |
| 25 | Non-Physician Practitioner - Group | Professional | Medical-Surgical Billing Manual |
| 26 | Osteopath | Professional | Medical-Surgical Billing Manual |
| 27 | Speech Therapist | Professional | Speech Therapy Billing Manual |
| 28 | Occupational Therapist | Professional | Physical and Occupational Therapy Billing Manual |
| 30 | Psychiatric Residential Treatment Facility (PRTF) | Institutional | Psychiatric Residential Treatment Facility Billing Manual |
| 32 |
| Institutional | |
| 33 | Dialysis Center | Institutional | Dialysis Billing Manual |
| 35 | Community Mental Health Center | Professional | |
| 36 | Home and Community-Based Services (HCBS) | Professional |
|
| 37 | Licensed Psychologist | Professional | |
| 38 | Licensed Behavioral Health Clinician | Professional | |
| 39 | Physician Assistant | Professional | Medical-Surgical Billing Manual |
| 40 | Certified Registered Nurse Anesthetist (CRNA) | Professional | Medical-Surgical Billing Manual |
| 41 |
| Professional | Medical-Surgical Billing Manual |
| 42 | School Speech Therapist | Professional | |
| 44 | Ambulatory Surgical Center (ASC) | Professional | Ambulatory Surgery Centers (ASC) Billing Manual |
| 45 |
| Institutional | |
| 46 | Developmental Evaluation Clinic | Professional | |
| 47 | Clinic - Dental | Professional | DentaQuest Colorado Medicaid Dental Program Provider Office Reference Manual (ORM) |
| 48 |
| Professional | Physical and Occupational Therapy Billing Manual |
| 49 | X-Ray Facility | Professional | Outpatient Imaging and Radiology Billing Manual |
| 50 | Hospice | Institutional | Hospice Billing Manual |
| 51 | School Health Services (SHS) | Professional | School Health Services Billing Manual |
| 52 | Residential Child Care Facility (RCCF) | Professional | Residential Child Care Facility (RCCF) Program (Mental Health Program) |
| 58 | Free Standing Birthing Center | Professional | Obstetrical Care Billing Manual |
| 60 | Personal Care Agency | Professional | Pediatric Personal Care Benefit Billing Manual |
| 61 | Indian Health Services (IHS) - Federally Qualified Health Center (FQHC) | Institutional | Indian Health Services Billing Manual |
| 62 | Indian Health Services (IHS) - Pharmacy | Institutional | Indian Health Services Billing Manual |
| 64 | Substance Use Disorder (SUD) Continuum | Professional | Outpatient Behavioral Health Fee-for-Service |
| 65 | Foreign Teaching Physician | Professional | Medical-Surgical Billing Manual |
| 66 | Dental Hygienist | Professional | DentaQuest Colorado Medicaid Dental Program Provider Office Reference Manual (ORM) |
| 68 | Qualified Residential Treatment Program (QRTP) | Professional | Qualified Residential Treatment Program Billing Manual |
| 70 | Lactation Consultant | Professional | Lactation Support Services Billing Manual |
| 71 | Lactation Counselor or Educator | Professional | Lactation Support Services Billing Manual |
| 72 | Lactation/Doula Professional Group | Professional | Lactation Support Services Billing Manual |
| 73 |
| Professional | Non-Emergent Medical Transportation (NEMT) Billing Manual |
| 74 | Supply Durable Medical Equipment (DME) (Social Security Number [SSN] Only) | Professional | Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Billing Manual |
| 75 | Pharmacist | Professional | |
| 77 | Behavioral Health Group | Professional | (Capitated Behavioral Health Benefit) State Behavioral Health Services Billing Manual |
| 78 | Comprehensive Safety Net Provider | Professional | (Capitated Behavioral Health Benefit) State Behavioral Health Services Billing Manual |
| 79 | Doula | Professional | Doula Billing Manual |
| 80 | Certified Midwife | Professional | Obstetrical Care Billing Manual |
| 81 |
| Professional | |
| 83 | Behavioral Therapy Clinic | Professional | Pediatric Behavioral Therapies Billing Manual |
| 84 | Behavioral Therapy - Individual | Professional | Pediatric Behavioral Therapies Billing Manual |
| 86 | Community Clinic (CC)/Community Clinic and Emergency Center (CCEC) | Institutional | Inpatient/Outpatient (IP/OP) Billing Manual |
| 88 | Behavioral Health Crisis Line | Professional | |
| 89 |
| Professional | |
| 97 | Behavioral Health Secure Transportation (BHST) | Professional | Behavioral Health Secure Transportation (BHST) Billing Manual |