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MedicaidReimbursementHigh impact

Special Provider Bulletin - Rate Reductions (B2500528 - 09/2025)

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

Summary

Colorado Medicaid is implementing rate reductions effective October 1, 2025, rolling back 1.6% fee increases across all professional and institutional claims due to state budget shortfall. Dental services, pediatric behavioral therapy, and some HCBS services face targeted reductions exceeding 1.6%, with dental codes reduced by 15.5%.

Action Required

Action needed
Before October 1, 2025: Billing team must update fee schedules in billing system to reflect new reduced rates for all Colorado Medicaid claims. Update dental procedure rates to new amounts listed (15.5% reduction from July 2024 rates). Update pediatric behavioral therapy rates to new amounts shown. Adjust all other professional and institutional rates by 1.6% reduction from current rates. Contact hospital rate specialists for specific inpatient/outpatient rate updates via provided email contacts.

Affected Billing Codes

97151
97153
97154
97155
97158
D0120
D0140
D0150
D1110
D1120
D1206
D1351
D1352
D1354
D2740
D2750
D2751
D2752
D2790
D2794
D2930
D3310
D3320
D3330
D3346
D3347
D3348
D4341
D4342
D4910