1

State Behavioral Health Services Billing Manual

This document sets forth the requirements of billing procedure codes for behavioral health services covered by HCPF and the Behavioral Health Administration (BHA). The State Behavioral Health Services Billing Manual (the billing manual) is a living document that is updated periodically to maintain consistency between the Regional Accountable Entity (RAE) and Managed Care Organization (MCO) -together referred to as Managed Care Entities (MCEs) - contracts, BHA contracts, State Plan Amendments, 1915(b)(3) waiver, and coding guidelines.

For copies of previous coding documents, please email hcpf_bhcoding@state.co.us.

To understand the history, design, content, and management approach of the billing manual, please see the Uniform Service Coding Standards (USCS) Manual Orientation.

Provider Support

For billing and coding questions, providers should contact your MCE:

For general questions related to existing content in the billing manual, providers can send questions to hcpf_bhcoding@state.co.us.  

For general questions related to BHA covered services and contracts, providers can send questions to cdhs_bha_provider_support@state.co.us.

For providers who are having challenges with claims, denials, conflicting guidance between MCEs, or other concerns, please submit your experience on this Provider Complaint Form. This form will be received by HCPF who will log your concern and then will forward it to the appropriate MCE for a response. Using this form will help HCPF identify common issues, trends, or systemic challenges that providers experience.

Coding Committee

HCPF facilitates a quarterly Coding Committee meeting to discuss coding questions, policy considerations, and requested edits to the billing manual with sister agencies (BHA, CDHS, etc.), Managed Care Entities (MCEs), and providers. This meeting serves as an advisory opportunity for HCPF to engage state policy subject matter experts, MCE representatives, expert behavioral health coders, and providers to review and discuss issues that impact content in the billing manual. HCPF relies on this consultation to ensure proper billing codes and methodologies are reflected in the billing manual, as well as ensuring alignment with billing guidance, the State Plan, and federal and state changes to rule or statute. In addition to State staff, the only required attendees are representatives from the MCEs which are responsible for managing the Capitated Behavioral Health Benefit.  

This meeting is not intended for general billing questions from providers. Providers are encouraged to reach out to their MCE or BHA program staff for specific billing questions.  For any suggestions to add, delete or change coding guidance in this manual please send these to your MCE(s) or BHA program staff.

This meeting will occur quarterly (February, May, August, and November), on the second Thursday of the month from 12:00 pm – 2:00 pm. I Meeting Link

Reasonable accommodations will be provided upon request for persons with disabilities. Please notify the 504/ADA Coordinator hcpf504ada@state.co.us at least one week prior to the meeting to make arrangements.

Coding Committee Minutes