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Billing Manuals

All manuals are in the Adobe Acrobat PDF format. You can download the free Adobe® Reader® by clicking on the link at the bottom of this page.

The manuals contain HIPAA updates. Providers are required to download and use the revised manuals.

General Provider Information (02/14)
This section contains essential general information common to all Colorado Medical Assistance Program providers. 



Colorado 1500






HCPCS / NDC Crosswalk for Billing Physician-administered Drugs (08/13)
This document provides Healthcare Common Procedure Coding System (HCPCS) codes and their corresponding National Drug Code (NDC) numbers for use in billing physician-administered drugs.

Eligibility Verification
The Department's fiscal agent and the Department's Customer Service staff are unable to provide guarantee numbers used to support client eligibility and coverage. Eligibility guarantee numbers may be received by verifying a client’s eligibility through one of the following electronic methods:

  • State's Web Portal (Batch or Interactive) X12N 270 - Eligibility Inquiry
  • Fax-Back: 1-800-493-0920 Toll free
  • CMERS1-800-237-0757

Maintain copies of all eligibility and coverage information in the client's file for billing purposes.

This document contains instructions on how to access and use the CMERS/IVRS Medicaid Eligibility System.

FaxBack Eligibility Instructions - This document contains instructions on how to access and use the FaxBack Medicaid Eligibility system. 


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