Behavioral Health Rate Reform

The Department is in the process of reforming the behavioral health rate-setting process.

The Department hires contractors to assist in the development and updating of documents for the Regional Accountable Entities (RAEs) that function as Behavioral Health capitated entities (BH RAEs), Community Mental Health Centers (CMHCs), and the Department. The Department, the BH RAEs, and the CMHCs will use these documents for capitated rate-setting purposes.

The final documents are a collaboration of feedback from the Department, the Behavioral Health Administration (BHA), and other stakeholders. The Department anticipates that further changes will be made to the posted documents and will set up a working group to provide input when updating the documents.

In compliance with HB 22-1268, the Department has created several documents to describe the current structure of the behavioral health safety net system. Per statute, the current safety net providers are paid on a cost basis and their costs are audited each year using the cost reports on this page. Below are some introductory documents into what a Community Mental Health Center (CMHC) is and what it is required to cover, how the cost report’s function, how to read the cost reports, and how the cost reports are used to set Medicaid behavioral health safety net rates. The audited cost reports for each of the CMHCs are also available on this page. Under HB 22-1278, the definitions of these safety net providers will be changing. As the licensure requirements, cost reports, and payment structures move forward, the Department will be updating these documents to reflect the changes. If you need more information about the current safety net system and the coming changes, please see our Behavioral Health Reform page.

Behavioral Health Alternative Payment Models

HB 22-1268 Rates Report and Action Plan

CMHC Cost Report Fact Sheets

FY 2023 Audited Cost Reports

CMHC Annual Cost Report Template

The below A&A Guidelines document updates the billable costs to Medicaid and BHA. Additionally, this document requires the CMHCs report costs in greater detail.

FY 2023 Accounting and Auditing

FY 2022 Accounting and Auditing

FY 2021 Accounting and Auditing

FY 2020 Accounting and Auditing

If you have need assistance or have any questions regarding any of these documents please contact Spencer Green at spencer.green@state.co.us.