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Colorado MedicaidMedicaid · Administrative · Provider Bulletin · COMedium impact

Health First Colorado (Colorado's Medicaid Program) News and Updates (B2300491 - 03/2023)

Effective date
Not stated in the notice
Identified
Jun 20, 2026

Summary

Providers must submit an initial claim within 365 days even if the result is a denial, and must resubmit claims every 60 days after the initial timely filing period to keep them within the timely filing period. Waiting for prior authorization or correspondence from the Department or the fiscal agent is not an acceptable reason for late filing. Effective January 26, 2023, all claims billed for Q0220, Q0221, M0220 and M0221 will be denied after the FDA stopped authorizing Evusheld for emergency use. The inpatient hospital co-pay is $25 per elective admission for dates of service beginning December 14, 2022, and procedure code E0445 is billed with modifier U1 for fingertip devices and U2 for tabletop devices for dates of service on or after January 1, 2023.

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What to do

Action · 6 steps
01Already effective January 1, 2023 (dates of service): Providers should use modifier U1 when billing fingertip pulse oximeters and modifier U2 for tabletop pulse oximeters under E0445, for purchase, monthly rental and daily rental claims.
02Already effective January 26, 2023: Claims billed for Q0220, Q0221, M0220 and M0221 will be denied.
03Timely filing (ongoing): Providers must submit the initial claim within 365 days of the date of service even if the result is a denial, resubmit claims every 60 days after the initial timely filing period, and reference the previous Internal Control Number (ICN) on claims over 365 days.
04Phone calls and other correspondence are not proof of timely filing.
05EFT (ongoing): If a provider receives a paper check when payments are usually received by EFT, verify that the change has been authorized, and contact the Provider Services Call Center if an EFT was submitted that was not authorized.
06Check current applicability of these dated items before acting on them.

Codes mentioned

E0445Q0220Q0221M0220M0221

Original notice

Health First Colorado (Colorado's Medicaid Program) News and Updates (B2300491 - 03/2023)
hcpf.colorado.gov · Always check the source before changing claims.
View original ↗

Related changes

See all Colorado Medicaid changes →
Health First Colorado (Colorado's Medicaid Program) News and Updates (B2200478 - 05/2022)MediumEffective Jul 1, 2022 · Provider BulletinHealth First Colorado (Colorado's Medicaid Program) News and Updates (B2200475 - 02/2022)MediumNo effective date · Provider BulletinHealth First Colorado (Colorado's Medicaid Program) News and Updates (B2200476 - 03/2022)MediumEffective Jul 1, 2022 · Provider BulletinHealth First Colorado (Colorado's Medicaid Program) News and Updates (B2200487 - 12/2022)MediumNo effective date · Provider BulletinBrowse every Colorado Medicaid change in the policy list

Related policy hubs

Colorado Medicaid policiesCO policy changesCode E0445Code Q0220Code Q0221Code M0220Code M0221

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