MedicaidAdministrativeHigh impact
Health First Colorado (Colorado's Medicaid Program) News and Updates (B2400507 - 04/2024)
Colorado Medicaid·CO · Psychiatry·Provider Bulletin
Effective date
Apr 1, 2024
We identified it
Jun 20, 2026
Summary
Colorado Medicaid (Health First Colorado) has implemented multiple billing changes effective April 1, 2024, including removal of HO modifier eligibility for Medicare-enrolled behavioral health practitioners and enforcement of OPR provider requirements for DME claims that will now deny if ordering providers aren't enrolled.
Action Required
By April 1, 2024: Behavioral health billing team must stop using HO modifier on claims for LMFTs, LPCs, and LACs who are enrolled in Medicare - bill Medicare first instead or claims will be denied by RAEs. DME billing team must verify all ordering/prescribing/referring providers are enrolled with Health First Colorado before submitting claims, as claims will now deny if OPR provider is not listed or enrolled. Update billing system edits to enforce these requirements.