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Health First Colorado (Colorado's Medicaid Program) News and Updates (B2200476 - 03/2022)

Colorado Medicaid·CO · Behavioral Health, Audiology, Dme Suppliers·Provider Bulletin
Effective date
Jul 1, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Colorado Medicaid (Health First Colorado) has implemented multiple billing changes including new license requirements in provider enrollment portals, mandatory ordering provider NPIs for audiology services starting July 1, 2022, and transfer of gender identity disorder billing to Regional Accountable Entities. DME safety equipment policies have been updated with new prior authorization requirements.

Action Required

Action needed
By July 1, 2022: Audiology providers must include ordering provider NPI in field 17.b on paper claims or loop 2420e with qualifier DK for electronic claims. Behavioral health providers must stop billing fee-for-service for gender identity disorders (F64.0-F64.9) and contract with Regional Accountable Entities instead. DME providers must confirm member education on proper installation for safety equipment codes E0241-E0246. Update billing systems to reflect these requirements or claims will be denied.

Affected Billing Codes

F64.0
F64.1
F64.2
F64.8
F64.9
E0241
E0242
E0243
E0246
A4436
A4437