MedicaidBilling CodesMedium impact
Health First Colorado (Colorado's Medicaid Program) News and Updates (B2300493 - 04/2023)
Colorado Medicaid·CO · General Surgery, Physical Therapy, Occupational Therapy +2 more·Provider Bulletin
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Summary
Colorado Medicaid (Health First Colorado) has issued multiple updates including new 2023 HCPCS codes, automated prior authorizations for autism therapy services, removal of prior auth requirements for certain hernia procedures, and updates to durable medical equipment coverage including continuous glucose monitors.
Action Required
Immediately: Update billing system to use new HCPCS codes A4239 (replacing K0553) and E2103 (replacing K0554) for DME services. Submit revision requests for existing PARs with old codes. Remove prior authorization requirements for hernia codes 49560, 49561, 49565, 49566, and 49568. For autism diagnoses F84.0 and F84.5, note that occupational therapy (92507, 92526, 92609) and speech therapy are now automatically authorized with specified frequency limits.