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Health First Colorado (Colorado's Medicaid Program) News and Updates (B2600539 - 06/2026)

Colorado Medicaid·CO·Provider Bulletin
Effective date
Jul 1, 2026
We identified it
Jun 20, 2026
Days to comply

Summary

Colorado Medicaid (Health First Colorado) is implementing a 2.0% across-the-board provider rate reduction effective July 1, 2026, affecting most services except pharmacy, rural health clinics, FQHCs, pediatric behavioral therapy, select NICU/neonatal and maternity services, and family planning. Additional targeted rate reductions apply to transportation services and a new $3,000 annual cap on adult dental services.

Action Required

Action needed
Before July 1, 2026: Billing team must update fee schedules and reimbursement expectations in billing system to reflect 2.0% rate reduction for Colorado Medicaid claims. Monitor Provider Rates & Fee Schedule web page for updated fee schedules once CMS approves rate adjustments. Verify exemptions apply correctly for pharmacy, RHC, FQHC, pediatric behavioral therapy, NICU/neonatal, maternity, and family planning services. Update financial projections and patient estimates for affected services.

Affected Billing Codes

A0100
A0120
S0215
S0209
96110