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Health First Colorado (Colorado's Medicaid Program) News and Updates (B2500530 - 10/2025)

Colorado Medicaid·CO · Dentistry·Provider Bulletin
Effective date
Oct 1, 2025
We identified it
Jun 20, 2026
Days to comply

Summary

Colorado Medicaid is implementing significant changes including a 1.6% rate reduction for all professional services effective October 1, 2025, with additional targeted cuts for dental and pediatric behavioral therapy services. The policy also includes mandatory DRA compliance documentation due November 1, 2025, and transitions for EDI vendors and pharmacy benefit management systems.

Action Required

Action needed
By November 1, 2025: Providers with $5M+ annual Medicaid payments must submit DRA Declaration for FFY 2024-2025 to HCPF_DRAAct2005@state.co.us. Immediately: Update billing system to reflect 1.6% rate reduction for all professional services effective October 1, 2025. Update fee schedules with new dental procedure rates. Contact EDI vendors to ensure they are aware of upcoming system transitions and file naming convention changes.

Affected Billing Codes

D0120
D0140
D0150
D1110
D1120
D1206
D1351
D1352
D1354
D2740
D2750
D2751
D2752
D2790
D2794
D2930
D3310
D3320
D3330
D3346
D3347
D3348
D4341