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MedicaidAdministrativeMedium impact

Health First Colorado (Colorado's Medicaid Program) News and Updates (B2100466 - 08/2021)

Colorado Medicaid·CO·Provider Bulletin
Effective date
Oct 1, 2021
We identified it
Jun 20, 2026
Days to comply

Summary

Health First Colorado (Colorado Medicaid) updated provider enrollment and disenrollment processes for ownership changes with new EINs, requiring re-enrollment and coordination between selling and new providers. The policy also introduced new requirements for PDMP checks before prescribing controlled substances and updated behavioral health fee schedules.

Action Required

Action needed
By October 1, 2021: Providers prescribing controlled substances to Colorado Medicaid patients must query the Colorado PDMP before prescribing. Update provider workflows to include PDMP checks. For practices undergoing ownership changes with new EINs: Complete new enrollment applications through Provider Enrollment Portal and coordinate disenrollment timing with selling providers to maintain continuity of care.

Affected Billing Codes

90791
90792
90832
90833
90834
90836
90837
90838
90839
90840
90846
90847
90849
90853
96105
96110
96125
96127
H0001
H0004
H0005
H0006
S9445
E1399