Denver Rate Billing Issue

Department of Health Care Policy & Financing

Dear Home and Community-Based Services Provider,

Modifier HX is required on some Home and Community-Based Services (HCBS) claims for services provided within the City and County of Denver, effective May 1, 2024. The HX modifier allows providers to bill for prior-authorized HCBS services with Denver County rates without needing to add the HX modifier to the HCBS Prior Authorization Request (PAR). The HX modifier is being added for HCBS services with Denver County rates in a phased approach.

The Adult Day Program Transportation codes for Mileage Bands 2 and 3 on the Complementary and Integrative Health (CIH) waiver changed on May 1, 2024, for services provided outside the City and County of Denver. These changes allowed for the addition of the HX modifier for services provided in Denver without needing to add the HX modifier to HCBS PARs.

Claims billed without the required HX modifier will need to be adjusted.

Refer to the HCBS Billing Manuals on the Billing Manuals web page for information on the updated HCBS codes.

Thank you,

Department of Health Care Policy & Financing