MedicaidAdministrativeHigh impact
Health First Colorado (Colorado's Medicaid Program) News and Updates (B2500524 - 06/2025)
Colorado Medicaid·CO·Provider Bulletin
Effective date
Jul 1, 2025
We identified it
Jun 20, 2026
Summary
Colorado Medicaid (Health First Colorado) has implemented multiple billing changes effective July 1, 2025, including a 1.6% across-the-board rate increase for most services and ended the grace period for claims requiring active enrollment of ordering/prescribing/referring providers. Claims will now be denied if referring providers are not actively enrolled for services like DME, home health, therapy, radiology, and lab services.
Action Required
Immediately: Verify all ordering, prescribing, and referring providers are actively enrolled with Health First Colorado to avoid claim denials for DME, home health, therapy, radiology, lab, and imaging services. Update provider affiliations within 5 days if EOB code 3110 appears. Check and update expired practitioner licenses through Provider Web Portal. Update billing system to reflect 1.6% rate increases effective July 1, 2025. Note that Community Health Worker services reimbursement is postponed until January 1, 2026.