Health First Colorado (Colorado's Medicaid Program) News and Updates (B2600537 - 04/2026)
Colorado's April 2026 Health First Colorado provider bulletin (B2600537) reduces applicable fee-for-service rates to 85% of their Medicare benchmark effective April 1, 2026, and requires a qualifying ICD-10 diagnosis within the first four diagnosis code positions on outpatient remote patient monitoring claims effective April 1, 2026. Repeat initial inpatient or observation E/M codes 99221 through 99223 on the same date of service must be billed with modifier 77 when the repeat service is distinct and medically necessary. Hospital Specialty Drug claims must carry the NDC, the NDC units, the acquisition cost and a drug-specific invoice, and fee-for-service pharmacy claims moved to MedImpact effective April 1, 2026.