MedicaidAdministrativeHigh impact
Health First Colorado (Colorado's Medicaid Program) News and Updates (B2400512 - 09/2024)
Colorado Medicaid·CO · Audiology, Physical Therapy, Occupational Therapy +2 more·Provider Bulletin
Effective date
Nov 1, 2024
We identified it
Jun 20, 2026
Summary
Colorado Medicaid has updated multiple provider requirements including mandatory inclusion of Ordering/Prescribing/Referring (OPR) provider NPIs on claims, DRA compliance documentation due November 1st for providers with $5M+ annual Medicaid payments, and various specialty-specific updates. Claims will be denied with EOB 1997 if OPR providers are missing or not enrolled.
Action Required
By November 1, 2024: Providers with $5M+ annual Colorado Medicaid payments must submit DRA Declaration and compliance documentation to HCPF_DRAAct2005@state.co.us. Immediately: Billing team must ensure all claims include enrolled OPR provider NPIs in field 17b (CMS 1500) or field 76 (UB-04) - this affects audiology, DME, home health, lab services, pediatric personal care, PT/OT/speech therapy, private duty nursing, radiology, and school health services. Update contact information in Provider Web Portal for ColoradoPAR communications.