MedicaidAdministrativeMedium impact
Health First Colorado (Colorado's Medicaid Program) News and Updates (B2300502 - 12/2023)
Colorado Medicaid·CO · Psychiatry·Provider Bulletin
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Colorado Medicaid has released a comprehensive provider bulletin with multiple policy updates effective at various dates. Key changes include new billing procedures for neuro/psychological testing (effective January 1, 2024), modifier HO changes for LMFTs/LPCs/LACs (effective April 1, 2024), and new substance use disorder specialty types. The bulletin also includes training opportunities and third-party liability reminders.
Action Required
By January 1, 2024: Behavioral health billing team must update procedures for neuro/psychological testing claims - determine primary payer (MCE or Fee-for-Service) based on referring diagnosis and add modifier SC when testing yields MCE-covered diagnosis but billing to fiscal agent. By April 1, 2024: Update billing system to restrict modifier HO usage to only situations where enrolled Medicare providers supervise unlicensed behavioral health providers. Update staff training on third-party liability rules to ensure members are never billed for co-pays/deductibles from commercial insurance.