MedicaidPrior AuthMedium impact
Health First Colorado (Colorado's Medicaid Program) News and Updates (B2100470 - 11/2021)
Colorado Medicaid·CO · Palliative Care·Provider Bulletin
Effective date
Dec 1, 2021
We identified it
Jun 20, 2026
Summary
Colorado Medicaid updates include new modifier GW requirement for DMEPOS claims for hospice patients (effective Dec 1, 2021) and phased restart of prior authorization requirements for Private Duty Nursing and Pediatric Long-Term Home Health services starting November 1, 2021.
Action Required
By December 1, 2021: Billing team must update system to require modifier GW on all DMEPOS claims and prior authorization requests for hospice patients when services are unrelated to terminal diagnosis. Update encounter forms to remind providers. Claims without proper modifier subject to recovery. For home health providers: Begin phased PAR submissions to Kepro via Atrezzo portal starting November 1, 2021 at 10% per month.