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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
11 days

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

Before Jul 1, 2026
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
Health First Colorado (Colorado's Medicaid Program) News and Updates (B2600539 - 06/2026) | Colorado Medicaid | PolicyChanges.app