Bulletins

Provider Bulletin Index

Provider Bulletin Index (11/21) - The Provider Bulletin Index contains a list of topics and sub-topics in current and prior year bulletins. To use the Index, simply find your topic and go to the bulletin for the date listed in the far right column. This is the bulletin in which the topic was published. If you have questions about Provider Bulletins, please contact the Provider Services Call Center.

The Provider Bulletin is published monthly and posted to this web page. The bulletin covers topics of interest to providers and billing professionals.

2021:B2100457-current

Health First Colorado (Colorado's Medicaid Program) News and Updates (B2100471 - 12/21) This bulletin contains information on Did You Know - Provider Web Portal Password Reset; National Correct Coding Initiative (NCCI) Notification of Quarterly Updates; Provider Enrollment Requirement; Update to Provider Participation Rule Section 8.130; Coverage of Electrolysis (Permanent Hair Removal); Home Dialysis for Recipients of Emergency Medicaid Services with End-Stage Renal Disease (ESRD); American Rescue Plan Act (ARPA) Billing for Home and Community-Based (HCBS) Services; Hospice Claims Selected for Potential Recovery Audit Contractor (RAC) Review; General Updates; COVID-19 Monoclonal Antibody Infusions; Reminder to Update Fax Numbers; Health First Colorado Preferred Drug List (PDL) Announcement of Preferred Products; Pharmacy and Therapeutics (P&T) Committee Meeting; Prior Authorization (PA) Update; Upcoming Diabetes Webinar Opportunity; Temporary Removal of Prior Authorization Requests for Specific Diagnostic Imaging Codes; December 2021 and January 2022 Provider Billing Webinar-Only Training Sessions

Health First Colorado (Colorado's Medicaid Program) News and Updates (B2100470 - 11/21) This bulletin contains information on Did You Know - Backdating a New Enrollment Application; Clarification of Hospice Rules Regarding DMEPOS; Philips Respironics Sleep and Respiratory Care Device Recall Update; Prior Authorization Request (PAR) Requirement Re-start Delay; General Updates; 2021 Flu Vaccine Code Update; License Prefix Change for Licensed Addition Counselors; House Bill (HB) 21-1275 Implementation; Prior Authorization Update; New Non-Emergent Medical Transportation (NEMT) Out-of-State Request Form; November and December 2021 Provider Billing Webinar-Only Training Sessions

Health First Colorado (Colorado's Medicaid Program) News and Updates (B2100469 - 10/21) This bulletin contains information on Did You Know - Delegates and the Provider Web Portal; Deficit Reduction Act of 2005 due November 1, 2021; Member Testimonial; Procedure Code S1040 Cranial Remolding Orthosis; Billing Manual Updates; Senate Bill (SB) 19-238 Reporting Timelines for Fiscal Year (FY) 2020-2021: Provider Web Portal Ready for Reporting; New Procedure Codes for Regional Center Billing for Members with the Developmental Disabilities (DD) Waiver; Group Rate Billing for Private Duty Nursing (PDN); Billing Manual Updates; Rate Update Effective October 1, 2021; General Updates; The Emergent Add-A-Baby Request Process; 2021 Flu Vaccine Code Update; Account Deactivation; Drug Utilization Review; Health First Colorado Announcement of Preferred Products; Pharmacy and Therapeutics (P&T) Committee Meeting; Pharmacy & Therapeutics (P&T) Committee Open Positions; COVID-19 Vaccine; Total Annual Prescription Volume (TAPV) Reminder COVID-19 Vaccines; Prior Authorization Update; Quarter 4 Rate Update 2021; Prior Authorization Request (PAR) Requirement Re-start Delay; Enrollment for New Program; Bed Count Updates; October and November 2021 Provider Billing Webinar-Only Training Sessions

Health First Colorado (Colorado's Medicaid Program) News and Updates (B2100468 - 09/21) This bulletin contains information on Did You Know - Verifying Eligibility Without the Member ID; National Correct Coding Initiative (NCCI) Notification of Quarterly Updates; Prescription Drug Monitoring Program and Controlled Substances; Updates to Colorectal Cancer Screening Policy; Fee-for-Service Prosthetic, Orthotic and Supplies Rate Rebalance Effective July 1, 2021; Upcoming Changes to Telehealth in Waivers Postponed; Opportunity to Provide Input on HCBS Case Management Redesign; Updates to Billing Procedure for Home Modification Second Unit; General Updates; Inpatient and Outpatient Supplemental Payment Adjustment Factors; The Emergent Add-A-Baby Request Process; COVID-19 Monoclonal Antibody Infusions; Updated Training for the Personal Care Assessment Tool; Health First Colorado Announcement of Preferred Products; Dispense as Written (DAW) Codes Usage for Billing Brand Products due to Generic Drug Shortages and Brand Favored Products; Pharmacy and Therapeutics (P&T) Committee Meeting; Pharmacy & Therapeutics (P&T) Committee Open Positions; Total Annual Prescription Volume (TAPV) Reminder and COVID-19 Vaccines; Prior Authorization (PA) Update; Modification for Contraceptive Pill Billing (S4993); No Rate Adjustments for Program Year 2020; Initial Per Diem Rate; September and October 2021 Provider Billing Webinar-Only Training Sessions

Special Provider Bulletin - Synagis® Vaccine Benefit (B2100467 - 08/21) This bulletin contains information on Synagis® (Palivizumab) Vaccine Benefit, Coverage and Reimbursement, Prior Authorization Requests (PARs) Submission Methods, Prior Authorization Requests (PARs) Criteria and Guidelines, Billing Instructions, Synagis® and Home Health Agencies

Health First Colorado (Colorado's Medicaid Program) News and Updates (B2100466 - 08/21) This bulletin contains information on Did You Know - Delayed Notification of Health First Colorado Eligibility; Upcoming Provider Enrollment Portal Update for Change of Ownership Applications and Provider Web Portal Update for Disenrollment Requests; New Prescriber Tool for Health First Colorado; Prescription Drug Monitoring Program and Controlled Substances; Fee-for-Service (FFS) Behavioral Health Rate Rebalance Effective April 1, 2021; Peristeen System Coding Update; General Updates; Replacement of Current Procedural Terminology (CPT) Codes with Healthcare Common Procedure Coding System (HCPCS) Codes; Increased Rate for Pediatric Personal Care; Brand Name Medication Favored Over Equivalent Generic; Pharmacy and Therapeutics (P&T) Committee Member Openings; Total Annual Prescription Volume (TAPV) and COVID-19 Vaccines; PADs Prior Authorization (PA) Update; Colorado Joint Vaccine Task Force Advises Providers to Take Every Opportunity to Vaccinate Every Eligible Person; Substance Use Disorder (SUD) Benefit Expansion Update; August and September 2021 Provider Billing Webinar-Only Training Sessions

Health First Colorado (Colorado's Medicaid Program) News and Updates (B2100465 - 07/21) This bulletin contains information on Did You Know - Member Programs Web Page; Child Health Plan Plus CHP+ State Managed Care Network (SMCN) Transition: How to Bill for CHP+ Services after July 1, 2021; Fiscal Year 2021-2022 Provider Rate Adjustments; Prior Authorization Required for Code L8687; First Notice: Claims Reprocessing Retroactive to July 1, 2020; Cholesterol Supplement Products; Early and Periodic Screening Diagnostic and Treatment (EPSDT) Requests for Wipes; Upcoming Changes to Telehealth in HCBS Waivers; General Updates; Hospital Transformation Program (HTP) Update; Replacement of Current Procedural Terminology (CPT) Codes with Healthcare Common Procedure Coding System (HCPCS) Codes; Fiscal Year 2021-2022 Rate Updates; New Pharmaceutical Benefit Help Guide; Pharmacy and Therapeutics (P&T) Committee Meeting; Pharmacy and Therapeutics (P&T) Committee Member Openings; Preferred Drug List (PDL) Announcement of Preferred Products; Total Annual Prescription Volume (TAPV) and COVID-19 Vaccines; PADs – Prior Authorization (PA) Update; Quarter 3 Rate Update 2021; Prior Authorization Requirement (PAR) for L3000; Targeted Rate Increase Effective July 1, 2021; Updated Rule Definition of a Payable Encounter RHCs; July and August 2021 Provider Billing Webinar-Only Training Sessions

 

Health First Colorado (Colorado's Medicaid Program) News and Updates (B2100464 - 06/21) This bulletin contains information on Did You Know - Reminder to Verify Member Eligibility; Child Health Plan Plus (CHP+) State Managed Care Network (SMCN) Transition: Provider Contracting; Expanded Age Range for Flu Vaccine Code 90688; Health Management Systems (HMS) Launches New Integrative Provider Portal for Third-Party Liability (TPL) and Recovery Audit Contract (RAC) Contracts for Health First Colorado Providers; Name Fields on the Disclosure Panels Updated in the Provider Web Portal; National Correct Coding Initiative (NCCI) Notification of Quarterly Updates; General Updates; Hospital Transformation Program (HTP) Update; Drug Utilization Review; New Pharmaceutical Benefit Help Guide; Pharmacy and Therapeutics (P&T) Committee Meeting; Pharmacy and Therapeutics (P&T) Committee Member Openings; Preferred Drug List (PDL) Announcement of Preferred Products; Reminder to Update Fax Numbers; PADs Prior Authorization (PA) Update; Policy and Procedures for Physician-Administered Drugs; June and July 2021 Provider Billing Webinar-Only Training Sessions

 

Health First Colorado (Colorado's Medicaid Program) News and Updates (B2100463 - 05/21) This bulletin contains information on Did You Know - Reconsiderations & Appeals; The Written Appeals Process; The Top Five Reasons Enrollment Applications are Returned to Providers; Provider Participation Rule Change; General Updates; Billing Changes for Twin or Other Multiple Births; Prior Authorization Update; Drug Utilization Review (DUR) Update - Pharmacy Claims Edit for Concomitant Opioid and Oral Buprenorphine-Containing MAT Therapy; Lead Poisoning Survey; May and June 2021 Provider Billing Webinar-Only Training Sessions

 

Special Provider Bulletin - Utilization Management (UM) Vendor Transition (B2100462 - 04/21) This bulletin contains information on the Transition Overview; ColoradoPAR Program: Utilization Management (UM) for Health First Colorado; Prior Authorization Request (PAR) Requirement for Home Health and In-state Inpatient Hospitals; Prior Authorization Requests (PARs) for Select Physician Administered Drugs; Utilization Management (UM) Vendor Transition Plan and Key Dates; Modification of Prior Authorization Requests (PARs) Completed by eQHealth Solutions; Key Changes Between eQHealth Solutions and Kepro; Kepro’s Provider Training Information; Kepro’s Provider Portal Registration Information; ColoradoPAR Program Web Page

 

Health First Colorado (Colorado's Medicaid Program) News and Updates (B2100461 - 04/21) This bulletin contains information on Did You Know - Website Redesign; Span Billing for Certain Supplies; Encounter Rate “Carve-Out” – COVID-19 Vaccine and Monoclonal Antibody Therapy Treatments; COVID-19 Monoclonal Antibody Infusions; New Utilization Management (UM) Vendor Update; General Updates; Hospital Transformation Program (HTP) Update; Increases in Medicaid Reimbursement for All COVID-19 Vaccine Administration; Johnson & Johnson Single-dose Vaccine Administration; Brand Name Medication Favored Over Equivalent Generic; Bydureon Discontinuation and Trulicity Preferred; Pharmacy and Therapeutics (P&T) Committee Meeting; Pharmacy and Therapeutics (P&T) Committee Member Openings; Preferred Drug List (PDL) Announcement of Preferred Products; Reminder to Update Fax Numbers; Value Based Contracting; Quarter 2 Rate Updates 2021; Telemedicine Report Available; April and May 2021 Provider Billing Webinar-Only Training Sessions

 

Health First Colorado (Colorado's Medicaid Program) News and Updates (B2100460 - 03/21) This bulletin contains information on Did You Know - Medicare Advantage Plans Billed as Medicare, Co-Pay and COVID-19, Health First Colorado Recovery Audit Contractor (RAC), Incorrect Member Billing, Member Video Toolkit, National Correct Coding Initiative (NCCI) Notification of Quarterly Updates, Hospital Services Rendered Via Telemedicine, Inpatient Hospital Review Program (IHRP): Suspension Continues, Updated Supervision Rules, Continued Suspension of the Prior Authorization Requirement, Preferred Drug List (PDL) Announcement of Preferred Products, Pharmacy and Therapeutics (P&T) Committee Meeting, Pharmacy and Therapeutics (P&T) Committee Member Openings, New Utilization Management (UM) Vendor Update, March and April 2021 Provider Billing Webinar-Only Training Sessions


Health First Colorado (Colorado's Medicaid Program) News and Updates (B2100459 - 02/21) This bulletin contains information on Did You Know -Keeping Claims Within Timely Filing, Provider Guidance for COVID-19 Vaccine Administration Delegation and Billing, Prescriber Tool Project, Geographic Rate Update, Correction to January Guidance, Update for E0118, New Utilization Management (UM) Vendor, Electronic Visit Verification (EVV) Update, Denver Minimum Wage Increase Effective January 1, 2021, General Updates, Hospital Transformation Program (HTP) Update, Prior Authorization for Specialty Drugs, Pharmacist Administration of COVID-19 Vaccines, Pharmacy & Therapeutics (P&T) Committee Member Openings, Prior Authorization Request (PAR) Suspension Information, February and March 2021 Provider Billing Webinar-Only Training Sessions


Health First Colorado (Colorado's Medicaid Program) News and Updates (B2100458 - 01/21) This bulletin contains information on the Healthcare Common Procedure Coding System (HCPCS) Updates for 2021, Discontinued Codes, New Procedure Codes, Procedure Codes with Description Changes.


Health First Colorado (Colorado's Medicaid Program) News and Updates (B2100457 - 01/21) This bulletin contains information on Did You Know - Provider Enrollment Application Fee, Direct Care Collaborative Starts in January, Member Billing, Member Video Toolkit, Social Security Verification for Revalidation Applications, Prescriber Tool Project, COVID-19 Vaccines, Sign Up to Receive Updates on the Upcoming Care and Case Management System Implementation, Physician Administered Drugs (PADs) - Healthcare Common Procedure Coding System (HCPCS)/ National Drug Code (NDC) Crosswalk Update, Multiple Line Items, Children's Habilitation Residential Program (CHRP) - Service Changes, General Updates, Hospital Transformation Program (HTP) Update, Reminder to Bill through IntelliRide, Preferred Drug List (PDL) Announcement of Preferred Products, Pharmacy and Therapeutics (P&T) Committee Meeting, Pharmacy and Therapeutics (P&T) Committee New Member Openings, Reminder to Update Fax Numbers, Quarter 1 Rate Updates 2021, COVID-19 Monoclonal Antibody Infusions, Benefit Expansion Go-Live, Residential and Inpatient SUD Provider Manual and Updates to Other Billing Manuals, Telemedicine Well-Child Check-Ups, January and February 2021 Provider Billing Webinar-Only Training Sessions

2020:B2000441 - B2000456

Health First Colorado (Colorado's Medicaid Program) News and Updates (B2000456 - 12/20) - This bulletin contains information on Did You Know - Procedure Code Updates and Coverage, National Correct Coding Initiative (NCCI) Notification of Quarterly Updates, National Provider Identification (NPI) Law, Prescriber Tool Project, Physician Administered Drugs (PADs) - Healthcare Common Procedure Coding System (HCPCS)/National Drug Code (NDC) Crosswalk Update, Changes to Room and Board (R&B) and Personal Needs Amounts (PNA), Children's Habilitation Residential Program (CHRP) Changes, Rendering Services, Home Modification Evaluation Billing, General Updates, Hospital Transformation Program (HTP) Update, Preferred Drug List (PDL) Announcement of Preferred Products, Pharmacy and Therapeutics (P&T) Committee Meeting, Pharmacy and Therapeutics (P&T) Committee New Member Openings, Medication Prior Authorization Request (PAR) Form Requirements, December 2020 and January 2021 Provider Billing and ClaimsXten™ Webinar-Only Training Sessions


Health First Colorado (Colorado's Medicaid Program) News and Updates (B2000455 - 11/20) - This bulletin contains information on Did You Know - Updating Delegate Status of Previous Employees in Provider Web Portal, Maintaining Current Licenses, Updating 1099 Address in Provider Web Portal, Upcoming Update to Increase Third-Party Liability (TPL) Records for Enhanced Cost Avoidance, Drug Acquisition Cost Survey - Physician-Administered Drugs (PADs) & Hospital Outpatient Services Drugs, Telemedicine Policy for FQHCs and RHCs Extended Beyond COVID-19 State of Emergency for Appropriate Procedure Codes, Senate Bill (SB) 19-238 Reporting Timelines for Fiscal Year (FY) 2019-2020: Provider Web Portal Ready for Reporting, Hospice Rate Updates- Fiscal Year 2020-2021, General Updates, Outpatient Hospital Therapy Services Billable Via Telemedicine, Capitation Recoupments for Deceased Members, Final Reminder to Bill through IntelliRide, Maternity Bundled Payment Program Goes Live, Pharmaceutical Rate Methodology, Pharmacist-Administered Adult Vaccines, Total Annual Prescription Volume (TAPV) Survey, Changes to Coding Guidelines for Evaluation and Management (E/M) Services, Upcoming Provider Enrollment for SUD Benefit Expansion, November and December 2020 Provider Billing and ClaimsXten™ Webinar-Only Training Sessions


Special Provider Bulletin - Synagis® and Seasonal Influenza Vaccines (B2000454 - 10/20) - This bulletin contains information on Synagis® (Palivizumab) Vaccine Benefit, Coverage and Reimbursement, Prior Authorization Requests (PARs) Submission Methods, Prior Authorization Requests (PARs) Criteria and Guidelines, Billing Instructions, Synagis® and Home Health Agencies, Seasonal Influenza Vaccine is a Benefit for Children and Adults, Children/Adolescents and Adults, Billing Information for Seasonal Influenza Vaccine


Health First Colorado (Colorado's Medicaid Program) News and Updates (B2000453 - 10/20) - This bulletin contains information on Did You Know - New Holiday to Replace Columbus Day, Colorado interChange Update for the State of Colorado Intercept Process, Colorado interChange Update - ClaimsXten™ Claims Editing Solution, COVID-19-Related Services for Recipients of Emergency Medicaid Services (EMS), Deficit Reduction Act (DRA) Documentation Due November 2, 2020, Healthy Communities Program for Members Shifted to Regional Accountable Entities (RAEs), New Mobile App for Health First Colorado and Child Health Plan Plus (CHP+) Members, We're Here for YOU, Colorado! Member Enrollment Campaign, Prior Authorization Request Supporting Documentation Reminder, Peristeen System Coverage Update, Attention DME-CRT and Assistive Technology Assessment Therapy Codes PA Update, Policy Change for Travel Time Billing, HCBS Rate Increases for Denver Minimum Wage, SB 19-238 Reporting Timelines for FY 2019-2020, Group Rate Billing, General Updates, Reminder to Bill through IntelliRide, COVID-19 Early Refill Override Removal, October Preferred Drug List (PDL) Announcement, Pharmacy and Therapeutics (P&T) Committee Meeting, Pharmacy and Therapeutics (P&T) Committee Open Positions, New FDA-Approved Medication for Spinal Muscular Atrophy, Pharmaceutical Rate Methodology, Pharmacy System Updates for Oral Buprenorphine Drugs for Medication-Assisted Treatment (MAT), Prescription Drug Average Acquisition Cost (AAC) Survey, Reminder to Update Fax Numbers, Total Annual Prescription Volume (TAPV) Survey, Quarter 4 Rate Updates 2020, Medicinal Treatment for Non-Viable Pregnancy Circumstances, Outpatient Speech Therapy Prior Authorizations Requests (PARs), ICD-10 Updates for Substance Use Disorder Conditions, October and November 2020 Provider Billing and ClaimsXten™ Webinar-Only Training Sessions


Health First Colorado (Colorado's Medicaid Program) News and Updates (B2000452 - 09/20) - This bulletin contains information on Did You Know - Provider Rates & Fee Schedule Web Page, Deficit Reduction Act (DRA) Documentation Due November 2, 2020, End of 2020 Payment Error Rate Measurement (PERM) Audit, National Correct Coding Initiative (NCCI) Notification of Quarterly Updates, Provider Enrollment Type Changes, Upcoming Colorado interChange Update - ClaimsXten™ Claims Editing Solution, Attention DME-CRT and Assistive Technology Assessment Therapy Codes PA Update, DME Oxygen for Members Enrolled in Denver Health Medicaid Choice or Rocky Mountain Health Plans Prime Managed Care Organizations (MCOs), Electronic Visit Verification (EVV) Compliance Timeline, General Updates, Age Range Update for Human Papilloma Virus (HPV) Vaccine, Replacement of CPT Codes with HCPCS Codes, October Preferred Drug List (PDL) Announcement, Brand / Generic Change for Albuterol HFA Inhalers, P&T Committee Meeting, P&T Committee Open Positions, Total Annual Prescription Volume (TAPV) Survey, Pharmaceutical Rate Methodology, Reminder to Update Fax Numbers, Well Care Visits Reminder, SUD Benefit Expansion, September and October 2020 Provider Billing and ClaimsXten™ Webinar-Only Training Sessions


Health First Colorado (Colorado's Medicaid Program) News and Updates (B2000451 - 08/20) - This bulletin contains information on Did You Know - Provider Web Portal Claim Attachment File Size Limit, Reminder to Update Contact Information for Member Search, Upcoming Colorado interChange Update - ClaimsXten™ Claims Editing Solution, Children's Habilitation Residential Program (CHRP) Training, General Updates, Replacement of Current Procedural Terminology (CPT) Codes with Healthcare Common Procedure Coding System (HCPCS) Codes, Nursing Facility Fiscal Year 2020-2021 Rate Updates, 48-Unit Benefit Limit in Provider Web Portal, Pharmacist-Administered Flu Vaccine for the 2020-2021 Flu Season, Regulatory Review of OAP Health and Medical Program Rules, August and September 2020 Provider Billing Webinar-Only Training Sessions


Health First Colorado (Colorado's Medicaid Program) News and Updates (B2000450 - 07/20) - This bulletin contains information on Did You Know - ConnectToCare Jobs Website for Health Care Employers, Fiscal Year 2020-2021 Provider Rate Adjustments, Help for the Uninsured During the Coronavirus (COVID-19) Pandemic, "Lower of" Pricing Logic for Rate Increases, Provider Recruitment - New Health First Colorado Providers Needed, Revalidation, Telemedicine Services, Contacting the Department's Prior Authorization Vendor, 1% Across the Board Rate Reduction Effective July 1, 2020, Temporary Suspension of Prior Authorization Request (PAR) Requirements, General Updates, Hospital Transformation Program (HTP) Update, Inpatient Hospital Review Program (IHRP) Suspended, Replace Current Procedural Terminology (CPT) Codes With Healthcare Common Procedure Coding System (HCPCS), Transportation Broker Expansion, Nasal Atomizer Billing, Pharmacy and Therapeutics (P&T) Committee Meeting, Guidelines for Early Intervention (EI) Therapy Providers, Quarter 3 Rate Updates 2020, July and August 2020 Provider Billing Webinar-Only Training Sessions.


Health First Colorado (Colorado's Medicaid Program) News and Updates (B2000449 - 06/20) - This bulletin contains information on Did You Know - Provider Revalidation Started, National Correct Coding Initiative (NCCI) Notification of Quarterly Updates, Guidance for COVID-19-Related Services for Recipients of Emergency Medicaid Services (EMS), Upcoming Improvements to Claims Review, Developmental Screening Changes, Pediatric Behavioral Therapy Criteria, Community Centered Boards and Single Entry Points Providing Case Management to Eligible HCBS Members, Nursing Facility National Provider Identifier (NPI), General Updates, Clinical Diagnostic Laboratory Upper Payment Limit Rates, Updates to Visit Documentation Policy, Preferred Drug List (PDL) Announcement of Preferred Products, Injectable Opioid Antagonists, Physician-Administered Drug (PAD) Billing Manual, Policies Relating to Ordering, Prescribing and Referring (OPR), June and July 2020 Provider Billing Webinar-Only Training Sessions


Health First Colorado (Colorado's Medicaid Program) News and Updates (B2000448 - 05/20) - This bulletin contains information on Did You Know - Provider Web Portal and Revalidation, Suspension of Payment Error Rate Measurement (PERM) Activities, Provider Benefits of Billing Third-Party Liability (TPL) (Commercial) Insurance, New ASC Grouper, General Updates, Requirement for OPR Providers to Enroll with Health First Colorado, Drug Utilization Review (DUR)Health First Colorado DUR Board Positions, HCPCS and NDC Crosswalk for Billing Physician-Administered Drugs (PADs), Preferred Drug List (PDL) Highlights, COVID-19-Related Pharmacy News, Centers for Disease Control and Prevention (CDC) Recommendations for Childhood Immunizations During COVID-19, May and June 2020 Provider Billing Webinar-Only Training Sessions


Health First Colorado (Colorado's Medicaid Program) News and Updates (B2000447 - 04/20) - This bulletin contains information on Did You Know - License Update Requirement, New Format for Provider Billing Manuals, Milliman Care Guidelines (MCG) 24th Edition Updates, Payment for Routine Dialysis Services, Electronic Visit Verification (EVV) Mandate Timeline, General Updates, Hospital Transformation Program (HTP) Update, Inpatient Hospital Review Program (IHRP) Suspension, Changing or Updating Surgical Procedure Codes on a Prior Authorization Request (PAR), Appeals Forms, Preferred Drug List (PDL) Announcement, April and May 2020 Provider Billing Training Sessions


Special Provider Bulletin - Long Acting Injectable Antipsychotics(B2000446 - 03/20) - This bulletin contains information on Coverage, Payment, and Billing for Long Acting Injectable Antipsychotics, Payment for Long Acting Injectables (LAIs), Physician Administered Drugs (PADs) Billing, Pharmacy, Rate Methodology


Health First Colorado (Colorado's Medicaid Program) News and Updates (B2000445 - 03/20) - This bulletin contains information on Did You Know - Timely Filing Requests, Change in Provider Services Call Center Hours, National Correct Coding Initiative (NCCI) Notification of Quarterly Updates, Provider Enrollment Updates Limited to One per Service Location, Timely Filing and Resubmissions, Explanation of Benefits (EOBs) Filtering for HCBS Providers, New Benefit - Youth Day Services, General Updates, Swing Bed Rate Effective January 1, 2020, Preferred Drug List (PDL) Announcement of Preferred Products, Updates to Healthcare Common Procedure Coding System (HCPCS), Health First Colorado (Colorado Medicaid) Selected for Federal Program to Reduce Maternal Opioid Misuse, Quarter 1 Rate Updates 2020, March and April 2020 Provider Billing Training Sessions


Health First Colorado (Colorado's Medicaid Program) News and Updates (B2000444 - 02/20) - This bulletin contains information on Did You Know - Provider Enrollment Address Must Match NPPES, Adding a New National Provider Identification (NPI) Number, Out-of-State Emergency Services, Provider Affiliations, Reconsiderations and Appeals, Reducing Prescription Drug Costs in Colorado, Verifying Eligibility, Unit Change to the Independent Living Service Training (ILST) on the Brain Injury (BI) Waiver, General Updates, Billing for Immediate Post-Partum Long-Acting Reversible Contraceptives (IPP-LARCs), Interim Billing for Diagnosis Related Group (DRG) Hospitals, Clinical, Diagnostic Laboratory Upper Payment Limit Rates, Genetic Testing Prior Authorization Requirement, Urinalysis Tests Information Update, Pharmacy Cost of Dispensing Survey, Drug Utilization Review Updates, Preferred Brand Updates, Quarter 1 Rate Updates 2020, Bi-Monthly Rural Health Clinic (RHC) Stakeholder Engagement Meetings, February and March 2020 Provider Billing Training Sessions


Special Provider Bulletin - Laboratories (B2000443 - 01/20) - This bulletin contains information on the Genetic Testing Prior Authorization Requirement and Clinical Diagnostic Laboratory Upper Payment Limit Rates


Health First Colorado (Colorado's Medicaid Program) News and Updates (B2000442 - 01/20) - This bulletin contains information on Did You Know - Current Licensure Requirement, National Correct Coding Initiative (NCCI) Notification of Quarterly Updates, Payment Error Rate Measurement (PERM) Audit, Prior Authorization Vendor Training, Changes to Billing Method for Home Accessibility Adaptations Benefit, Changes to Supported Living Program (SLP) Rate Methodology, Targeted Rate Increases Effective January 1, 2020, General Updates, Hospital Transformation Program (HTP), Inpatient Hospital Review Program (IHRP) Materials, Inpatient Hospital Review Program (IHRP) Admission Date, Immediate Post-Partum Long-Acting Reversible Contraception (IPP-LARC) Carve-Out From All Patient Refined-Diagnosis Related Group (APR-DRG) Payment Methodology, Genetic Testing Prior Authorization Requirement, Rx Review Program, Preferred Drug List (PDL) Announcement of Preferred Products, Eligibility Criteria for Enbrel, Humira, Cosentyx or Xeljanz IR, Pharmacy and Therapeutics (P&T) Committee Meeting, Pharmacy & Therapeutics (P&T) Committee Open Positions, Quarter 1 Rate Updates 2020, January and February 2020 Provider Billing Training Sessions


Special Provider Bulletin - Healthcare Common Procedure Coding System (HCPCS) Updates for 2020 (B2000441 - 01/20) - This bulletin contains information on the Healthcare Common Procedure Coding System (HCPCS)Updates for 2020, Discontinued Codes, New Procedure Codes, Procedure Codes with Description Changes.

2019:B1900425 - B1900440

Health First Colorado (Colorado's Medicaid Program) News and Updates (B1900440 - 12/19) -This bulletin contains information on Did You Know - Provider-Member Billing Reminder, Deficit Reduction Act of 2005 Provider Requirements, eQSuite® Trainings, Load Letters, Prior Authorization Requests (PARs) Determination Letter Change Reminder, Update on Known Issue for Claims Paying at Zero Incorrectly, Changes to Room and Board and Personal Needs Amounts, General Updates, Hospital Back Up (HBU) Rate Corrections - December 2019, Hospital Transformation Program (HTP), Inpatient Hospital Review Program (IHRP), Inpatient Medicare Part B-Only and Medicare Part A Exhaust Claims Pricing, Brand Name Medication Favored Over Equivalent Generic, Preferred Drug List (PDL) Announcement of Preferred Products, Vivitrol Administration Enhanced Reimbursement, Dry Needling 97799 Update, Rates Updates for Non-Clinical Diagnostic Laboratory Upper Payment Limit (CDL-UPL), December 2019 and January 2020 Provider Billing Training Sessions


Health First Colorado (Colorado's Medicaid Program) News and Updates (B1900439 - 11/19) -This bulletin contains information on Did You Know - Unlocking or Resetting a Provider Web Portal Password, Colorado National Provider Identifier (NPI) Law Implementation, Fingerprint - Federal Criminal Background Check, Payment Error Rate Measurement (PERM) Audit, eQSuite® User Administrators, Pre-Admission Screening and Resident Review (PASRR), General Updates, Inpatient Hospital Review Program (IHRP) Updates, New Skin Substitute Rates, Quarter 4 Rate Updates 2019, Reallocation Change Form Templates, Brand Name Medication Favored Over Equivalent Generic, October and November 2019 Provider Billing Training Sessions


Special Provider Bulletin - Synagis® & Seasonal Influenza Vaccines (B1900438 - 10/19) - This bulletin contains information on the Synagis® (Palivizumab) Vaccine Benefit, Reimbursement of Synagis®, Prior Authorization Requests (PARs) Submission Methods, Prior Authorization Requests (PARs) Criteria and Guidelines, Billing Instructions, Synagis® and Home Health Agencies, Seasonal Influenza Vaccine is a Benefit for Children and Adults, Children/Adolescents and Adults, and Billing Information for Seasonal Influenza Vaccine


Health First Colorado (Colorado's Medicaid Program) News and Updates (B1900437 - 10/19) - This bulletin contains information on Did You Know - Process for Refunding Payments, Enrollment Application Date of Birth (DOB) Requirement Reminder, Updated Process for Member Date of Death Verification, Non-Covered Modalities Under the Occupational Therapy Benefit, Child Health Plan Plus (CHP+) Prenatal Dental Benefit, Unit Limit Update for Procedure Code T2003, Electronic Visit Verification (EVV) Training Announcement, Hospice Facility Fiscal Year 2019-2020 Rate Updates, General Updates, Hospital Transformation Program (HTP) Program Updates, Medicare Crossover Claim Billing and Payment Updates for State Funded Mental Health Institutes (MHIs), Urinalysis Test Policy Clarification, Drug Utilization Review Update to Pharmacy Prior Authorization Form for Medications Administered in a Member's Home or in a LTCF by a Healthcare Professional, Preferred Drug List (PDL) Announcement of Preferred Products, Total Annual Prescription Volume (TAPV) Survey, Tobacco Cessation Reminder, PAD Billing Guidance, Quarter 4 Rate Updates 2019, Abortion Services Update, October and November 2019 Provider Billing Training Sessions


Special Provider Bulletin - Reporting Service Units for Outpatient Physical, Occupational and Speech Therapy Benefits (B1900436 - 10/19) - This bulletin contains information on the Reporting of Service Units for the Outpatient Physical, Occupational and Speech Therapy Benefits


Health First Colorado (Colorado's Medicaid Program) News and Updates (B1900435 - 09/19) - This bulletin contains information on Did You Know -Prior Authorization Request (PAR) Must Be Approved When Claim is Submitted, Annual ICD-10 Coding Updates Effective October 1, 2019, National Correct Coding Initiative (NCCI) Notification of Quarterly Updates, National Provider Identifier (NPI) Regulations, Payment Error Rate Measurement (PERM) Audit, Provider Web Portal Update to Add Remove Link to Service Details Section, Claims Must Match Documentation, Federal Upper Payment Limit (UPL) Requirement, Peristeen - Pricing, Data Analysis & Coding (PDAC)-Appropriate Coding, General Updates, Hospital Transformation Program (HTP) - Program Updates, Quarter 3 Rate Updates 2019, Drug Utilization Review Updates, September and October 2019 Provider Billing Training Sessions


Health First Colorado (Colorado's Medicaid Program) News and Updates (B1900434 - 08/19) - This bulletin contains information on Did You Know - Medicare Replacement Plan, Billing Education-Only Telemedicine Services, Reminder to Update Contact Information for Member Search, Billing Guidelines for Bus Passes, In-Home Support Services (IHSS) Provider Updates, New Services for the Home & Community-Based Services - Children's Habilitation Residential Program (HCBS-CHRP) Waiver, Personal Care & Homemaker Provider Meetings, General Updates, Hospital Transformation Program (HTP), Billing Modifiers for Bilateral Radiology Procedures, Drug Utilization Review Updates, Medications Administered in a Member's Home or in a Long Term Care Facility (LTCF) by a Health Care Professional, Dispense-As-Written (DAW) Reminders, Preventive Services Billing, Quarter 3 Rate Updates 2019, New Non-Emergent Medical Transportation (NEMT) Broker, August and September 2019 Provider Billing Training Sessions


Health First Colorado (Colorado's Medicaid Program) News and Updates (B1900433 - 07/19) - This bulletin contains information on Did You Know - Electronic Claim Submission Requirement, Clinical Trial Coverage, "Lower of" Pricing Logic for Rate Increases, Payment Error Rate Measurement (PERM) Audit, Updates to Eligibility Verification, PAR Determination Letter Change, General Updates, Hospital Transformation Program (HTP) Update, Inpatient Medicare Part B-Only and Medicare Part A Exhaust Interim Solution Update, End-Stage Renal Disease (ESRD) Vascular Access Procedures for Recipients of Emergency Medicaid Services, New Grant Opportunity, Medication Administration, Quarter 3 Rate Updates 2019, July and August 2019 Provider Billing Training Sessions


Health First Colorado (Colorado's Medicaid Program) News and Updates (B1900432 - 06/19) - This bulletin contains information on Did You Know - TPL Updates via Provider Web Portal, Fiscal Year 2019-2020 Provider Rate Increases and Adjustments, "Lower of" Pricing Logic for Rate Increases, National Correct Coding Initiative (NCCI) Notification of Quarterly Updates, Delta Dental Switch to DentaQuest, General Updates, Hospital Transformation Program (HTP) Community and Health Neighborhood Engagement (CHNE), Inpatient Hospital Review Program (IHRP) Update, Newborn Hearing Screening, Newborn Metabolic Screening, Laboratory Rate Rebalancing Effective July 1, 2019, Genetic Testing Prior Authorizations and Rates Information, 340B Drug Pricing Program, Stiripentol (Diacomit), Brand Name Medication Favored Over Equivalent Generic, Drug Utilization Review Updates, Pharmacy and Therapeutics (P&T) Committee Meeting, Preferred Drug List (PDL) Announcement of Preferred Products, Instructions for Claims Submission with Procedure Code 38439, Supervision Requirements for Reimbursable Services, June & July 2019 Provider Billing Training Sessions


Health First Colorado (Colorado's Medicaid Program) Special Bulletin - Newborn Screenings (B1900431 - 05/19) - This bulletin contains information on Newborn Hearing Screening and Newborn Metabolic Screening


Health First Colorado (Colorado's Medicaid Program) News and Updates (B1900430 - 05/19) - This bulletin contains information on Did You Know -Timely Filing for Claim Resubmissions, "Lower of" Pricing Logic for Rate Increases, Regulatory Efficiency Review Public Notice - 30-Day Comment Period, Duplicate Billing of Services Rendered by a Certified Registered Nurse Anesthetist (CRNA) Supervised by an Anesthesiologist, Medicare Crossover Claim Reimbursement, Colorado Choice Transitions (CCT) Program Extension, New Services Available, Under the HCBS-CHRP Waiver, New Sustainability Services Available Under Certain HCBS Waivers, New Targeted Case Management - Transition Coordination Benefit for Colorado Choice Transitions Transition Coordination Agency (CCT-TCA) Providers, Training for In-Home Support Services Now Available, Billing Guidelines for Bus Passes, Self-Audit for Active Certifications and Licenses, General Updates, Hospital Transformation Program (HTP) Overview & Resources, Inpatient & Outpatient CHASE Supplemental Payment Percentage Adjustment Factors, Code Updates, 340B Drug Pricing Program, Brand and Generic Equivalent Changes for Non-Preferred Medications, Quarter 2 Rate Updates 2019


Health First Colorado (Colorado's Medicaid Program) News and Updates (B1900429 - 04/19) - This bulletin contains information on Did You Know - Member Eligibility Verification Availability, Fingerprint Criminal Background Check (FCBC), Verifying Member Eligibility and Appealing Claim Denials for Eligibility, Claims Must Match Documentation, Geographical Reimbursement Rates, Modifiers, Updated Prior Authorization Request (PAR) Requirements for Prosthetics & Orthotics, Effective April 1, 2019, House Bill (HB) 18-1407 Implementation, Billing Guidance for End-Stage Renal Disease as an Emergency Medical Condition, Inpatient Hospital Review Program (IHRP) Implementation Notification, General Updates, 340B Drug Pricing Program, Pharmacy Acquisition Cost Survey, April Preferred Drug List (PDL) Announcement, Drug Utilization Review Updates, Changes to Sleep Study and Pulmonary Testing Procedure Codes, Place of Service (POS) 19 and 22 for Hospital-Based Clinics, Policy Update Requiring a Prior Authorization Request (PAR) for Back Surgery and Other Select Surgical Codes, Unlisted Surgical Code Pricing and Billing Bilateral Procedures, Prior Authorization Required for Outpatient Speech Therapy, April and May 2019 Provider Billing Training Sessions


Health First Colorado (Colorado's Medicaid Program) News and Updates (B1900428 - 03/19)- This bulletin contains information on Did You Know - Service Limits, Prior Authorizations and the EPSDT Benefit, National Correct Coding Initiative (NCCI) Notification of Quarterly Updates, Requesting a Backdated Enrollment Effective Date, Reminder to Verify Member Eligibility Prior to Rendering Services, Peristeen® Expanding to Adults, Policy Clarification Requiring Provider IDs for FQHCs, CCT Reauthorization, Urinalysis Tests Information, General Updates, Dispense as Written (DAW) Override Code Reminder, Brand Name Medications in Generic Mandate-Exempt Classes on the Preferred Drug List (PDL), Drug Utilization Review Updates, Quarter 1 Rate Updates 2019, Policy Update Requiring a Prior Authorization Request (PAR) for Back Surgery and Other Select Surgical Codes, Policy Update Requiring Prior Authorization (PA) for Speech Therapy, Non-Emergent Medical Transportation (NEMT) Process Change, March and April 2019 Provider Billing Training Sessions


Health First Colorado (Colorado's Medicaid Program) News and Updates (B1900427 - 02/19) - This bulletin contains information on Did You Know- National Provider Identifier (NPIs) and Multiple Locations, Remittance Advices (RAs) and ERA X12 835 Reports Schedule Change, Remittance Advice (RA) Reports Must Be Obtained Through the Provider Web Portal, Remittance Advice (RA) Update to Help Providers Reconcile Payments, How to Bill for Short-Term Behavioral Health Services in the Primary Care Setting, Quarter 1 Rate Updates 2019 for Physician-Administered Drugs, Policy Clarification for Health First Colorado Benefit on Wipes, General Updates, End-Stage Renal Disease to be Considered an Emergency Medical Condition, Vivitrol® Injections and Pharmacist Immunizations, February & March 2019 Provider Billing Training Sessions


Health First Colorado (Colorado's Medicaid Program) Special Bulletin - HCPCS Updates 2019 (B1900426 - 01/19)- This bulletin contains information on the Healthcare Common Procedure Coding System (HCPCS) Updates for 2019, Discontinued Codes, New Procedure Codes, and Procedure Codes with Description Changes


Health First Colorado (Colorado's Medicaid Program) News and Updates (B1900425 - 01/19) - This bulletin contains information on Did You Know - Suspended Claims and Timely Filing, Healthcare Common Procedure Coding System (HCPCS) Updates for 2019, New Fraud, Waste and Abuse Web Page, Provider Enrollment Change Regarding a Backdated Enrollment Effective Date, Colorado Choice Transitions (CCT) Program Ending, Federal Upper Payment Limit (UPL) Requirement, Targeted Rate Increase, Colorado Adult Protective Services (CAPS) Data System, Non-Medical Transportation Services Targeted Rate Increase Approved, General Updates, End-Stage Renal Disease to be Considered an Emergency Medical Condition, Update to Outpatient Speech Therapy Prior Authorization Requirement, New Immunization Codes Added for Shingrix and Heplisav, Hospital Back-Up (HBU) Reimbursement Methodology Update, Post-Eligibility Treatment of Income (PETI) Prior Authorization Request (PAR) Approver for Nursing Facilities, Preferred Drug List (PDL) Announcement, Drug Utilization Review Updates, Vivitrol Injections and Pharmacist Immunizations, January & February 2019 Provider Billing Training Sessions

2018:B1800409 - B1800424

Medicaid Program News and Updates (B1800424 - 12/18) - This bulletin contains information on Did You Know - Current Processing Times for Provider Enrollment, Delayed Notification of Member Eligibility, Healthy Communities Program, National Correct Coding Initiative (NCCI) Notification of Quarterly Updates, Revenue Codes Under the Capitated Behavioral Health Benefit, Service, Mailing and Billing Addresses, Enrollment Required for CC and CCEC Providers, Peristeen Expanding to Adults, Cost-of-Living Adjustment (Increases), General Updates, Upcoming Policy Stakeholder Meeting Regarding Emergency Dialysis Policy and Hospital Readmission, New Billing Manual for IHS Providers, Preferred Drug List (PDL) Announcement, Drug Utilization Review (DUR) Updates, 340B Drug Pricing Program, 340B Policy and Procedures Manual, Pharmacist Enrollment: Over-the-Counter (OTC) Drugs and Immunizations, and December 2018 and January 2019 Provider Billing Training Sessions


Medicaid Program News and Updates (B1800423 - 11/18) - This bulletin contains information on Did You Know - Known Issues Web Page, Fingerprint - Federal Criminal Background Check (FCBC), Backdate Enrollment Form, Upcoming Improvements to Remittance Advice (RA) Financial Transactions Page, General Updates, Telligen Selected for Long-Term Care Utilization Management Contract, Outpatient PT/OT Policy Updates, Pharmacy & Therapeutics (P&T) Committee Open Positions, Drug Utilization Review Updates, 340B Drug Pricing Program, 340B Policy and Procedures Manual, Pharmacist Enrollment: Over-the-Counter (OTC) Drugs and Immunizations, Pricing for Unlisted Surgery CPT Codes, Upcoming Changes to Outpatient Speech Therapy Prior Authorizations Requirements, and November and December 2018 Provider Billing Training Sessions


Special Provider Bulletin - Synagis® & Seasonal Influenza Vaccines (B1800422 - 10/18) - This bulletin contains information on the Synagis® (Palivizumab) Vaccine Benefit, Reimbursement of Synagis®, Prior Authorization Requests (PARs) Submission Methods, Prior Authorization Requests (PARs) Criteria and Guidelines, Billing Instructions, Synagis® and Home Health Agencies, Seasonal Influenza Vaccine is a Benefit for Children and Adults, Children/Adolescents and Adults, and Billing Information for Seasonal Influenza Vaccine


Medicaid Program News and Updates (B1800421 - 10/18) - This bulletin contains information on Quick Guides and Webinars Web Page, Load Letters, Member Contact Center Hours Changing, ColoradoPar Training with eQHealth Solutions Inc®, Health First Colorado (Colorado's Medicaid Program) Recovery Audit Contractor (RAC) Begins Work, Provider Enrollment Type Changes, Reminder: Request for Reconsideration is Not Necessary for Denied Claims, Ear Mold Coverage Policy, HCBS Waiver Program Post Payment Review Contract, Final Notice: Vision Therapy Services for Children and Youth Enrolled in the Children's Extensive Services (CES) Waiver Are Now Provided Under State Plan, Hospice Legislative Rate Increases Effective October 1, 2018, Hospital General Updates, 340B Drug Pricing Program, 340B Policy and Procedures Manual, Pharmacist Enrollment: Over-the-Counter (OTC) Drugs and Immunizations, Total Annual Prescription Volume (TAPV) Survey, Drug Utilization Review Updates, October Preferred Drug List (PDL) Announcement, Q4 Rate Updates, Multiple Surgery Billing Procedures, Billing Bilateral Procedures, and October and November 2018 Provider Billing Training Sessions.


Medicaid Program News and Updates (B1800420 - 09/18)- This bulletin contains information on Checking Member Usage for PT/OT Services on Provider Web Portal, NCCI Notification of Quarterly Updates, Billing Gender-Specific Procedures for Transgender Members, Upcoming Improvements to Remittance Advice (RA) Financial Transactions Page, New Medicare Cards, Prosthetics & Orthotics PAR Announcement, ACF Targeted Rate Increase Approved, Environmental Survey on Current Technology Usage of HCBS Providers, General Updates, Enrollment Now Open for CC and CCEC Providers, Circumcision PAR Requirements, 340B Drug Pricing Program, New 340B Policy and Procedures Manual, Rx Review Program Update, October Preferred Drug List (PDL) Announcement, Colorado MAPIR Accepting Health First Colorado EPs and EHs Attestations, and September and October 2018 Provider Billing Training Sessions.


Medicaid Program News and Updates (B1800419 - 08/18) - This bulletin contains information on Member Contact Center Phone Number, Using a Previous Internal Control Number (ICN), Accountable Care Collaborative (ACC) Phase II - What Providers Need to Know, Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Services and Requests, Uniform Service Coding Standards Manual July 2018, Continuation of Benefits During a Member Appeal, Hospital - General Updates, Update to Imaging and Radiology Billing and Policy Manual, 340B Drug Pricing Program Provider Notice, Drug Utilization Review Announcements, Physician-Administered Drugs, Rendering Provider Number Requirement, and Physician-Administered Drug Acquisition Cost Surveys.


Medicaid Program News and Updates (B1800418 - 07/18) - This bulletin contains information on Change of Ownership, Accountable Care Collaborative (ACC) Phase II Launches July 1, 2018, eQSuite® User Administrators for Colorado PAR Portal, Fiscal Year 2018-2019 Provider Rate Increases and Adjustments, National Correct Coding Initiative (NCCI) Notification of Quarterly Updates, Behavioral Health Provider Type Changes, Physician-Administered Drug (PAD) Acquisition Cost Surveys, Children with Autism (CWA) Waiver Has Ended, Hospital General Updates, Inpatient & Outpatient Colorado Healthcare Affordability & Sustainability (CHASE) Supplemental Health First Colorado Payment Percentage Adjustment Factors, Nursing Facility Fiscal Year 2018-2019 Rate Updates, July 2018 Physical and Occupational Therapy (PT/OT) and Speech Therapy Updates, Pharmacy Updates, Colorado Medical Assistance Provider Incentive Repository (MAPIR) Accepting Health First Colorado-Eligible Professionals (EPs) and Eligible Hospitals (EHs) Attestations


Medicaid Program News and Updates (B1800417 - 06/18) - This bulletin contains information on Do Not Submit Paper Claims for Dates of Service Over 365 days, Reminder: Reference the Special Provider Bulletin for Colorado interChange Common Questions, Timely Filing Period Extended to 365 Days - Effective June 1, 2018, Fiscal Year (FY) 2018-2019 Provider Rate Increases and Adjustments, Co-Pay Collection, Managed Care Organization (MCO) Laboratory Policy, Fingerprint Criminal Background Check, Children with Autism Waiver Ending June 30, 2018, Rate Updates, Hospital Meetings, Technical and Professional Component Modifiers on Outpatient Hospital Claims, Preferred Drug List (PDL) Announcement, Technical and Professional Component Modifiers on Professional Claims, Non-Emergent Medical Transportation (NEMT) Non-Covered Services, Supplemental Payment for University of Colorado School of Medicine


Anesthesia Provider Bulletin (B1800416 - 05/18) - This bulletin contains information on Anesthesia Payment Policy Changes.


Medicaid Program News and Updates (B1800415 - 05/18) - This bulletin contains information on Keep Your Provider Profile Information Up to Date, Fingerprint Criminal Background Check (FCBC), Accountable Care Collaborative (ACC) Phase II: Important Information about Provider Contracting, Prior Authorization Requests (PARs) Through eQHealth Solutions Guidance, Federal Upper Payment Limit (UPL) Requirement, Manual Pricing Billing Process Change - By Invoice, Reminder to Providers: Claims Must Match Documentation, General Updates, PAR Not Needed for Emergencies, Kyleena: New HCPCS Code and Other Long-Acting Reversible Contraceptive (LARC) Information, Preventive Services Billing, PAD - Drugs and Biologicals Discarded/Not Administered to Any Member (JW Modifier), Opioid Treatment Naive Policy, Drug Utilization Review (DUR) Announcements


Special Provider Bulletin - Accountable Care Collaborative: Important Information for Primary Care & Behavioral Health Providers (B1800414 - 04/18) - This bulletin contains information on Provider Contracting, Resources Available on the ACC Phase II Web Page, Contacting Your RAE, Stay Informed

Special Provider Bulletin - Colorado interChange Common Questions (B1800413 - 04/18) - This bulletin contains information on Do Not Send Reconsiderations for Denied Claims, Electronic Submission of Claims with Attachments, Provider Web Portal Void Claim Option Appears Only on Eligible Claims, When to Attach Explanation of Benefits (EOB) on Third Party Liability (TPL) and Medicare Claims, Unique National Provider Identifiers (NPIs): Making Claim Submission Easier, Paper Claim Form Signature Requirements, Claims Paid with 0 Date, Suspended Claims, "Lower of" Pricing Logic for Rate Increases, Rates and Fee Schedules, Finding Information About Your Submitted Claims (What Is an ICN?), Timely Filing, Ordering, Prescribing or Referring (OPR) Application Not Required for Individual Within a Group (IWG) Providers with Prescriptive Authority, Individual Providers Enrolling with an SSN May Only Have One Medicaid ID, Department Grace Period for Updating Provider Affiliations, Retroactive Updates to Member Eligibility Files, Alternative Benefit Plan


Medicaid Program News and Updates (B1800412 - 04/18) - This bulletin contains information on Did You Know? - "Lower of" Pricing Logic for Rate Increases, Fingerprint - Federal Criminal Background Check (FCBC), Reminder: Health First Colorado (Colorado's Medicaid Program) Members Cannot Be Billed for Services, Accountable Care Collaborative (ACC): New Resources for Providers, Health First Colorado Recovery Audit Contractor (RAC) Begins Work, Updates to CMS 1500 Specialty Manual and Appendix T Billing Guidance, Federal Upper Payment Limit (UPL) Requirement, Manual Pricing, DMEPOS Billing Manual Update, Reminder to Providers: Claims Must Match Documentation, State Requirements to Receive the Medicare Low Volume Payment (LVP) Adjustment in Hospital's Medicare Base Rate, Monthly Enhanced Ambulatory Patient Groups (EAPG) Meetings, Mass Adjustment of Xerox EAPG Claims Update, Specialty Hospital Meetings, Hospital Engagements Meetings, Rule Changes for In-Home Support Services (IHSS), April Preferred Drug List (PDL) Announcement, Upcoming Changes for Sedative Hypnotic Medications, Requiring Indications for Growth Hormone Agents, Drug Utilization Review (DUR) Announcements, Date of Service (DOS) Reminder, Pharmacy Cost of Dispensing Survey, Pricing for Unlisted Surgical Procedure Codes, Physician-Administered Drug Rates, Diabetes Self-Management Education (DSME) Coverage, Speech Therapy Coverage Determination Notice, Hospital Discharge Process


Medicaid Program News and Updates (B1800411 - 03/18) - This bulletin contains information on Sign Up for Provider Email Communications, Fingerprint - Federal Criminal Background Check, Healthcare Common Procedure Coding System (HCPCS) Updates for 2018, National Correct Coding Initiative (NCCI) Notification of Quarterly Updates, Pediatric Behavioral Therapies (PBT) Fiscal Year (FY) 2017-2018 Rate Updates, Revised Psychological/Neuropsychological Billing Policy, Brand/Generic Changes, April Preferred Drug List (PDL) Announcement, Federal Upper Payment Limit (UPL) Requirement, Manual Pricing, Reminder to Providers: Claims Must Match Documentation, Addressing Reimbursable Claims that Pay Zero, General Updates, March 2018 PT/OT/ST Billing Manual Update, Pharmacy Updates, New Circumcision Rates Effective March 1, 2018, Hospital Discharge Transportation Billing Update, Updated Billing Manuals, Supplemental Payment for University of Colorado School of Medicine


Medicaid Program News and Updates (B1800410 - 02/18) - This bulletin contains information on Did You Know? - Verifying member eligibility, Child Health Plan Plus (CHP+) Update, Fingerprint Criminal Background Checks, 2018 Health Care Procedural Coding System (HCPCS) Codes Annual Update, Effective March 1, 2018 - Checks for Refund Payment Must Be Made Out to Colorado Department of Health Care Policy and Financing, CMS 1500 and UB-04 Paper Claim Form Reminder, Spinal Cord Injury Pilot Waiver Annual Report Published, Community Mental Health Supports (CMHS)
Fiscal Year (FY) 2017-18 Rates Updates Approved, Long-Term Home Health (LTHH) Services Prior Authorization Requests (PARs), Hospital General Updates, Emergency Supply While Waiting for Prior Authorization (PA) Determination, Drug Utilization Review (DUR) Updates, Provider Type Restrictions, New Provider Types, Drug Recall and Safety Alert: Clopidogrel 75 mg tablets, Pharmacy Cost of Dispensing Survey, Date of Service Reminders, Unenrolled Prescribers: NEW Prescriptions Written by Prescribers Not Enrolled with Health First Colorado Began Denying on January 1, 2018.

Medicaid Program News and Updates (B1800409 - 01/18) - This bulletin contains information on Did You Know? - Void Claim Option, Fiscal Year (FY) 2017-2018 Provider Rate Increases and Adjustments, Child Health Plan Plus (CHP+) Update, Health First Colorado (Colorado's Medicaid Program) and CHP+ Member Feedback Wanted, How Organizations Can Utilize Colorado's Newly Approved Health IT Roadmap, Tax Year 2017 1099-MISC Forms, Transportation Benefits Collaborative Meeting, Co-Pay Policy Update, Physician-Administered Drugs Billed with Miscellaneous J Codes Require National Drug Code (NDC) Number, Healthcare Common Procedure Coding System (HCPCS) Code, and NDC Units, Physician-Administered Drug Rate Update, Drug Utilization Review (DUR) Updates, Unenrolled Prescribers: NEW Prescriptions Written by Prescribers Not Enrolled with Health First Colorado Will Deny Beginning January 1, 2018, Pharmacy Provider Updates, HCPCS 0159T No Longer Covered, Non-Emergent Medical Transportation (NEMT) Bus Ticket Modifiers, Guidance for Billing CPT 92015 for Determination of Refractive State.

2017:B1700391 - B1700408
Special Provider Bulletin - Co-payment Policy Updates (B1700408 - 12/17) - This bulletin contains information on Co-payment Policy Updates, Co-payment Increase for Health First Colorado Members Effective January 1, 2018, Co-payment Limit for Health First Colorado Members, and Resources on the Department's interChange Resource Web Page.

 


Medicaid Program News and Updates (B1700407 - 12/17) - This bulletin contains information on Did You Know? - How to Read Claims: Information on the ICN (Claim Number), Timely Filing Frequently Asked Questions (FAQs), Important Information for Child Health Plan Plus (CHP+) Providers, ColoradoPAR Updates, Co-Pay Limit for Health First Colorado Members, Colorado Health IT Roadmap Approved, OeHI Seeks Public Comment on Key Roadmap Initiative, National Correct Coding Initiative (NCCI) Notification of Quarterly Updates, CMS 1500 and UB-04 Paper Claim Form Reminder, Co-Pay Policy Update, Specialty Code Update - Community Transition Services (CCT), General Updates, Community Clinics with Emergency Centers, Important NF/SNF/ICF Provider Updates, Update to Billing Manual, Drug Utilization Review (DUR) Updates, Pharmacy Provider Updates, No Cost Sharing for Tobacco Cessation Medications, Colorado Medical Assistance Provider Incentive Repository (MAPIR) Accepting Medicaid Eligible Professionals (EPs) and Eligible Hospitals (EHs) Attestations, Supplemental Payment for University of Colorado School of Medicine, and Billing Guidance for Medically Necessary Eyeglass Frames for Members Under 21 Years Old


Medicaid Program News and Updates (B1700406 - 11/17) - This bulletin contains information on Did You Know? - Reconsiderations not Required on Claim Denials, ColoradoPAR Provider Educational Resources, Co-Pay Limit for Health First Colorado Members, Child Health Plan Plus Update, Claim Submission Method for Claims with Attachments, Videos Now Available for Download, Coding Update: Miscellaneous Disposable Supplies - T5999, Reminder: Face-to-Face (F2F) Requirement, General Updates, Delay in Immediate Post-Partum Long-Acting Reversible Contraception (IPP-LARC) Carve-Out from APR-DRG Payment Methodology, Billing for Global Obstetrical (OB) Care, Legal Abortion Claim Documentation Requirements and Use of the Department's Form(s) (Abortion Certification Statement) Required, Sterilization Consent Forms and Partial or Unilateral Reproductive Tissue Surgical Procedure Claim Requirements, Exceeding 48 Units, Bowel Preparation Agents: Monthly Quantity Limit, Total Annual Prescription Volume (TAPV) Survey, Drug Utilization Review (DUR) Updates


Special Provider Bulletin - Synagis® & Seasonal Influenza Vaccines (B1700405 - 10/17) - This bulletin contains information on the Synagis® (Palivizumab) Vaccine Benefit, Seasonal Influenza Vaccine, Colorado Pharmacy Medicaid Synagis® Information Sheet, Colorado Medicaid Synagis® Pharmacy Benefit PA Form.


Medicaid Program News and Updates (B1700404 - 10/17) - This bulletin contains information on Did You Know? - The Provider Web Portal is down for regularly scheduled maintenance every Wednesday night, Temporary Filing Extension Update, Colorado PAR Information, Child Health Plan Plus Update, Revised Behavioral Health Laboratory Policy, Drug Utilization Review (DUR) Announcements, Coding Update: Miscellaneous Disposable Supplies - T5999, Secretary of State (SOS): DME Supplier License, Rate Increases, Inpatient Base Rate & Outpatient Hospital Supplemental Medicaid Payment Interim Percentage Adjustment Factors for Federal Fiscal Year (FFY) 2017-18, Hospital Updates, Hospital Discharge Transportation, Inter-Facility Transportation, Outpatient Therapy Coding, Outpatient Therapy Manuals Updated, Long Term Care (LTC) Pharmacy Partial Fills for CII Prescriptions, Drug Classes and Preferred Agents, Total Annual Prescription Volume (TAPV) Survey, Colorado Medical Assistance Provider Incentive Repository (MAPIR) Accepting Medicaid Eligible Professionals (EPs) and Eligible Hospitals (EHs) Attestations, Temporary Change in Transportation Claiming for Fiscal Year (FY) 2016-17 Cost Report, New Vision and Eyewear Rule Implemented Effective September 30, 2017.


Medicaid Program News and Updates (B1700403 - 09/17) - This bulletin contains information on Did You Know? - Claim Denials for (EOB) 2580 Appear for a Medical or Mental Health Service, NPI Numbers, Claim Submission Method for Claims with Attachments, Load Letter Information Update, NCCI Notification of Quarterly Updates, ColoradoPAR (eQHealth) Information and Updates, Urinalysis Tests Information Update, Hospital Updates, Circumcision Coverage, Behavioral Health Lab Policy, Important NF/SNF/ICF Provider Updates, Increase in Reimbursable Maternal Depression Screenings, Outpatient Therapy Coding, Coding Changes,DUR Announcements, Pharmacy Provider PAR Approval and Denial Letters, Pharmacy Member PAR Approval Letters, TAPV Survey, SBIRT Approved Screening Tools, Supplemental Payment for University of Colorado School of Medicine.


2017 Hospital Provider Special Bulletin (B1700402 - 08/17) - This bulletin contains information on the Stakeholder Meeting for CMS-Certified Community Clinics and Community Clinics with Emergency Centers.


Medicaid Program News and Updates (B1700401 - 08/17) - This bulletin contains information on Did You Know? - Claims Paid with Paid Date of 0, Accountable Care Collaborative (ACC): Access KP Program Ends, Members Enrolled in Colorado Access, ColoradoPAR Information, Supply, Pharmacy with Durable Medical Equipment (DME), Hospital Transportation Policy Information, Inpatient & Outpatient Hospital Supplemental Medicaid Payment Percentage Adjustment Factors, Newly Issued FY 2017-18 Outpatient Enhanced Ambulatory Patient Grouping (EAPG) Base Rates, New System Mass-Adjustment Coordination and Hospital Engagement Meetings, Opioid Policy Updates, Physician-Administered Drugs, Drug Utilization Review (DUR) Board Meeting, Update on Vision Claims Denied Incorrectly for Prior Authorization Requirements.


Medicaid Program News and Updates (B1700400 - 07/17) - This bulletin contains information on Did You Know? - EOB Code 3110 on Claim Affiliation Edit Only Informational, New Provider Rates, Legislative Increases and General Information, SB 16-120 Member Explanation of Benefits (EOB) Implementation Delay, DMEPOS Billing Updates, Medicare Billing Enforced, Re-Issued FY2017-18 Inpatient Base Rates, New System Mass-Adjustment Coordination and Hospital Engagement Meetings, Important Information for 340B Providers, Partial Fills for Long Term Care (LTC) Members, DAW 9 and DAW 8, Magellan Contacts, Brand - Generic Changes, Evaluation Codes, Use of Evaluation and Management Procedure Codes for Integrated Services, Physician-Administered Drugs Require both National Drug Code (NDC) Number and HCPCS Code, Changes in End of Life Counseling Benefit, Including Medical Orders for Scope of Treatment (MOST), Clinical Laboratory Improvement Amendments (CLIA) Billing, New Code for Kyleena: A New Long-Acting Reversible Intrauterine Contraceptive (LARC), Immediate Post-Partum Long-Acting Reversible Contraception (IPP-LARC) Carve-out from All Patient Refined-Diagnosis Related Group (APR-DRG) Payment Methodology, and New HCPCS Codes for 17-Alpha-Hydroxyprogesterone Caproate (17P) Injections.


Medicaid Program News and Updates (B1700399 - 06/17) - This bulletin contains information on Did You Know? - Provider Guide for Reading Remittance Advice, Visit the Known Issues Web Page, Monitoring Prior Authorization Request (PAR) Submissions through eQSuite, Accountable Care Collaborative (ACC) Request for Proposals (RFP) Now Available, Paper Claim Form Requirement Change, Fingerprint - Federal Criminal Background Check, National Correct Coding Initiative (NCCI) Notification of Quarterly Updates, Face-to-Face Encounter Requirements for Home Health Services Initiated on or after July 1, 2017, Inpatient Hospital Base Rates FY2017-18, New System Mass-Adjustment Coordination and Hospital Engagement Meetings, Important Information for 340B Providers, Brand and Generic Changes, Drug Classes and Preferred Agents.


Medicaid Program News and Updates (B1700398 - 05/17) - This bulletin contains information on Did You Know? - Suspended Claims Only Show Once on RA, Name Change for HPE, Extended Provider Service Call Center Hours, Temporary Timely Filing Extension, News and Updates for Known Issues, Fingerprint - Federal Criminal Background Check, Claims Denied or Suspended Due to Multiple Rendering Enrollment Profiles, Remittance Advices (RAs) and 835s, Updates Impacting Secondary Claims, Load Letters, CMS 1500 Paper Claim Form Requirement Change, Fall Screening & Risk Reduction Webinars, Hospital Engagement Meetings 2017, Drug Utilization Review (DUR) Board, and Over-the-Counter (OTC) Products


Medicaid Program News and Updates(B1700397 - 04/17) - This bulletin contains information on Did You Know? - Transition Special Bulletin, CMS 1500 Paper Claim Form Requirement Change, Timely Filing Reminder and Changes to Late Bill Override Dates (LBOD) in Colorado iC, Provider Web Portal Enrollment, Resources, and FAQs, eQHealth Prior Authorization Request (PAR) Revisions, Changes for Pharmacy Claims and Prior Authorization Processing, Important Information for 340B Providers, and April Preferred Drug List (PDL) Announcement.


Go-Live Transition Special Bulletin (B1700396 - 03/17) - This bulletin contains information on Hewlett Packard Enterprise (HPE) is now Live with the New interChange System, CMS 1500 Paper Claim Form Requirement Change, What Does 'Suspended' Mean?, Are you Getting One of the Following Claim Messages?, Obtaining or Correcting an NPI on the Provider Web Portal, Home Health and Nursing Facility Billing Changes, Enrollment, Payment Reminders, and Provider References.


Medicaid Program News and Updates (B1700394 - 03/17) - This bulletin contains information on Did You Know? - Reminder to Retrieve Reports Prior to 3/11/17, Health First Colorado Now Live with the New interChange and Provider Web Portal, Resources for Health First Colorado and Child Health Plan Plus Providers, Fingerprint - Federal Criminal Background Check, Accountable Care Collaborative Phase II Update - Draft Request Comments, Influenza Immunization Code Changes for 2017, National Correct Coding Initiative Notification of Quarterly Updates, Children with Autism Modifier Code Change, Durable Medical Equipment, Prosthetics, Orthotics and Supplies, Information for 340B Providers, Vision Billing Manual and Fee Schedule Changes, Additional Hospital Billing Changes, Hospital Engagement Meetings 2017, Resubmitting Denied Claims Containing ICD-10 New Diagnosis Codes, Outpatient Hospital Crossover Medicare and Medicaid Claims, and Pharmacy Prior Authorization Request Notification.


2017 Hospital Provider Special Bulletin (B1700395 - 02/17) - The bulletin contains important information on acceptable hospital billing practices.


Medicaid Program News and Updates (B1700392 - 02/17) - This bulletin contains information on the Did You Know? - HCPCS Special Bulletin, Deadline for Electronic Medical Claims Submissions, Timely Filing Reminder and Changes to Late Bill Override Dates (LBOD) in the New System, Are You Ready for March 1, 2017, Co-Payment Policy Changes Effective March 1, 2017, Updates to 2016-17 ICD-10 New Diagnosis Codes and Upcoming Hospital Engagement Meetings, Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Updates, Colorado PAR Documentation, Person- and Family-Centered Approach to Creating a Culture of Collaboration with Clients, Telemedicine Stakeholder Meeting, Community Clinic with Emergency Center Enrollment, Tax Season and 1099s, Keeping Your Information Up to Date, February 2016 Holidays, 2016-17 Inpatient Hospital Rates Updates, Important Actions for Nursing Facility Providers, Epinephrine Dosing and Drug Utilization Review Board (DUR) Meeting, and Pharmacy Dispensing Fees for Calendar Year 2017.


2017 Practitioner HCPCS Special Bulletin (B1700393 - 01/17) - This bulletin contains information on 2017 Practitioner HCPCS, including Updates for 2017, Discontinued Codes, Code Description Changes, and New Procedure Codes.


Medicaid Program News and Updates (B1700391 - 01/17) - This bulletin contains information on Did You Know? - Provider Revalidation Deadline, Frequently Asked Questions About Medicaid Expansion, 2017 HCPCS Annual Updates, Clarification of Breast Cancer Susceptibility Gene (BRCA) Testing for Men, Timely Filing Reminder and Changes to Late Bill Override Dates in the New System, Accountable Care Collaborative Phase II Update - Draft Request for Proposals (RFP), Tax Season and 1099s, Keeping Provider Info Up to Date, January and February 2016 Holidays, Billing and Program Updates from DentaQuest, HCPCS Updates for 2017 - Current Dental Terminology (CDT) Changes, Changes to Orthodontia Process: Effective January 1, 2017, Interim Therapeutic Restorations (ITR) Added to Registered Dental Hygienist (RDH) Scope of Practice: Effective January 1, 2017, Discontinuation of Home Health Type of Bill 33X: Effective March 1, 2017, and the Xerox Transition to Conduent.

2016:B1600377 - B1600390

Medicaid Program News and Updates (B1600390 - 12/16)- This bulletin contains information on the Revised Go Live Date for the New Colorado interChange, Provider Web Portal, and Pharmacy Benefits Management System, New Call Center for Revalidation and Enrollment Assistance, Reminder About New Ordering, Prescribing, or Referring (OPR) Provider Regulations, Revalidation/Enrollment Application Fee - Increase Effective January 1, 2017, Accountable Care Collaborative (ACC) Phase II Update, National Provider Identifier (NPI) Number Needed for Rendering and Referring Providers on Professional Claims, Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS), Recovery Audit Contractor (RAC), National Correct Coding Initiative (NCCI) Notification of Quarterly Updates, Tax Season and 1099s, Please Keep Your Information Up-to-Date, Holiday Schedule 2016-17, Rx Review Program - Update, January Preferred Drug List (PDL) Announcement, Pharmacy and Therapeutics Committee Meeting, and New Plan Information.


Medicaid Program News and Updates (B1600389 - 11/16) - This bulletin contains information on the Revised Go Live Date for the New Colorado interChange, Provider Web Portal, and Pharmacy Benefits Management System, New Call Center for Revalidation and Enrollment Assistance, Reminder About New Ordering, Prescribing, and Referring (OPR) Regulations, ACC Phase II Update: Request for Proposals and Stakeholder Engagement Opportunities, Telemedicine Policy Updates, eQHealth New Provider Reference Guides, Tax Season and 1099s, Attention Providers: Please Keep Information Up to Date, November 2016 Holidays, Behavioral Health Services at a Federally Qualified Healthcare Centers (FQHC), Notice of Skilled Nursing Facility (SNF) Change of Ownership - Cottonwood Care Center, Impact of interChange Launch Postponement on Enhanced Ambulatory Patient Grouping System (EAPGS) Implementation for Outpatient Hospital Services, and Immunization Rate Schedule - Effective July 1, 2016.


Synagis and Seasonal Influenza Vaccines Special Bulletin (B1600388 - 10/16) - This bulletin contains information on the Synagis® (Palivizumab) Vaccine, Reimbursement and Prior Authorization (PAR) of Synagis®, Pharmacy PAR Requests, Medical PAR Requests, Synagis® and Home Health Agencies, Seasonal Influenza Vaccine is a Benefit for Children and Adults, Children/Adolescents and Adults, and Billing Information as of October 1, 2016.


Medicaid Program News and Updates (B1600387 - 10/16) - This bulletin contains information on the Health First Colorado Provider Enrollment and Revalidation, ColoradoPAR, Colorado's New Medicare-Medicaid Advocate, Accepting Applications for the Member Experience In-Person and Virtual Advisory Council, PainNet Access, Recovery Audit Contractor (RAC), Columbus Day Holiday, Discontinuation of Home Health Type of Bill 33X: Effective October 1, 2016, Notice of SNF Change of Ownership - Autumn Heights Health Care Center, Notice of SNF Change of Ownership - Mesa Vista of Boulder, and Inpatient Base Rate & Outpatient Hospital Supplemental Medicaid Payment.

10/12/2016 - Correction: A previous version of the bulletin misstated the date of discontinuation for Home Health Type of Bill 33X. The discontinuation date is October 31, 2016.


Medicaid Program News and Updates (Special Revalidation and Enrollment Guide - 09/16) - This bulletin contains information on Provider Revalidation and Enrollment, Upcoming Deadlines to Submit Claims and PARs, Delays in Payment, Trading Partners in interChange for Batch Claim Submitters, Training on the New Systems, and the Provider Resources Web Page.


Medicaid Program News and Updates (B1600386 - 09/16) - This bulletin contains information on the Accountable Care Collaborative Phase II Update: Request for Proposals and Federal Waiver Authority, Colorado's New Medicare-Medicaid Advocate, Big Changes to the Provider Portal & Pharmacy Benefits Management System (PBMS), Facilitated Provider Testing of the New Provider Web Portal, Cross-Agency Effort to Improve Member Eligibility Correspondence, ColoradoPAR Program Updates, Coding Changes to the Health First Colorado Fee-for-Service Primary Care Depression Screening Benefit Reminder, National Correct Coding Initiative (NCCI) Notification of Quarterly Updates, Obtaining or Replacing Health First Colorado (Colorado's Medicaid Program) Cards, Record Retention, September 2016 Holiday, Unit Limit and Prior Authorization Review, Billing Manual Updates, Liletta Intrauterine Device - Product Change Notification for NDC, Inpatient Rates and All Patient Refined Diagnosis Related Group (APR-DRG) Recalibration Update, Attention Imaging and Radiology Providers, Preferred Drug List (PDL) Update, Hepatitis C Medication Prior Authorization Process, Pharmacy and Therapeutics Committee Meeting, and the Transition of Pharmacy Benefit Management Services to Magellan Rx Management.


Medicaid Program News and Updates (B1600385 - 08/16) - This bulletin contains information on Health First Colorado Provider Revalidation Updates, Provider Enrollment Process, New Videos for Health First Colorado (Colorado's Medicaid Program) Members, Practitioner Claims Submitted Via Web Portal, Big Changes to the Provider Portal, MMIS, and PBMS, ColoradoPAR Program Updates, ACC: Access KP Payment Reform Initiative, New Recovery Audit Contractor, Update Provider Contact Information Maintained in the Medicaid Management Information System (MMIS), Hospice Room and Board Rates Update, Updates to Outpatient Cost-to-Charge Ratios and Enhanced Ambulatory Patient Grouping System (EAPGS) Implementation, Inpatient Claims for Members Fewer Than 29 Days Old, Attention Imaging and Radiology Providers, Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Unit Limit and Prior Authorization Review, Total Transit Has a New Name, and August 2016 Provider Workshops.


Medicaid Program News and Updates (B1600384 - 07/16) - This bulletin contains information on Colorado Medicaid Now Called Health First Colorado, New Recovery Audit Contractor, Big Changes to the Provider Portal, Medicaid Management Information System, and Pharmacy Benefits Management System, Health First Colorado Provider Revalidation Important Update, Regulatory Efficiency Review, Electronic Funds Transfer (EFT) Setup for New Provider Enrollments, Provider Address Reminder, ColoradoPAR Program Updates, Rate Changes for Evaluation and Management (E&M) and Vaccine Administration Services, Health First Colorado Nurse Advice Line, 2016 Payment Error Rate Measurement (PERM) Audit, July 2016 Holiday, Inpatient Base Rate & Outpatient Hospital Supplemental Medicaid Payment, New Web Hub for Immunization Information, Maternity Services - Revision of Billing for Delivery of Multiple Gestations, Attention Outpatient Radiology and Imaging Providers, New Vendor for Setting Average Acquisition Costs (AAC) Rates, Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Unit Limit and Prior Authorization Review, Billing Manual Updates, Preferred Drug List (PDL) Update, Pharmacy and Therapeutics Committee Meeting, Drug Utilization Review (DUR) Board Update, Attention Outpatient Physical and Occupational Therapists, and Provider Workshops.


Medicaid Program News and Updates (B1600383 - 06/16) - This bulletin contains information on Big Changes to the Provider Portal, Medicaid Management Information System (MMIS), and Pharmacy Benefit Management System (PBMS), Long Bill Has Been Signed: Outlines Funding for Fiscal Year 2017, Medicaid Provider Revalidation Update, Electronic Fund Transfer (EFT) Setup for New Provider Enrollments, ACC: Access KP Payment Reform Initiative, 2016 Payment Error Rate Measurement (PERM) Audit, ColoradoPAR Program Updates, National Correct Coding Initiative (NCCI) Notification of Quarterly Updates, Free Screening, Brief Intervention, and Referral to Treatment (SBIRT) Training for Medicaid Providers, Accredited Diabetes Self-Management Education (DSME) Providers and Program Staff: We Want to Hear from You!, July 2016 Holiday, Billing and Program Updates from DentaQuest, Take 5 Pay for Performance Program Update, All Patient Refined Diagnosis Related Group (APR-DRG) Version Update, Attention Outpatient Physical and Occupational Therapists, Preferred Drug List (PDL) Update, Pharmacy and Therapeutics Committee Meeting, Drug Utilization Review (DUR) Board Update, Inhaled Corticosteroid Combinations, New Vendor for Setting Average Acquisition Cost (AAC) Rates, Rx Review Program Upcoming Cycle, Attention speech-Language Pathology Providers, Home and Community Based Services (HCBS) Providers Post-Payment Review Audit Announcement, and June and July Provider Workshops.


Medicaid Program News and Updates (B1600382 - 05/16) - This bulletin contains information on the Medicaid Provider Revalidation Update, Provider Address Reminder, ACC Phase II Update: New Stakeholder Resources, Access Monitoring Review Plan (AMRP), What is Payment Error Rate Measurement?, Rendering, Referring, and Prescribing Providers NPI Numbers, ColoradoPAR Program Updates, Free Screening, Brief Intervention, and Referral to Treatment (SBIRT) Training for Medicaid Providers, Discontinued Codes, May 2016 Holiday, Ambulatory Surgery Center Rates Update, Behavioral Therapy Updates, Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Billing Manual Updates, Reminder to Providers: PARs for Additional Units, Attention Speech-Language Pathology Providers, Total Transit Has revised Non-Emergency Medical Transportation (NEMT) Forms, and May and June 2016 Provider Workshops.

Medicaid Program News and Updates (B1600381 - 04/16) - This bulletin contains information on Rendering, Referring, and Prescribing Provider's NPI Numbers, Medicaid Provider Revalidation Update, ACC Phase II Update: Behavioral Health Reimbursement Framework & FAQs, Free Screening, Brief Intervention, and Referral to Treatment (SBIRT) Training for Medicaid Providers, Person and Family Centered Approach: Creating a Culture of Collaboration with Members, National Correct Coding Initiative (NCCI) Notification of Quarterly Updates, ColoradoPAR Program Updates, Discontinued Codes, Tax Season and 1099s, Food and Drug Administration (FDA) Update on Essure: Female Sterilization Method, Inpatient Claims for Members Fewer than 29 Days Old, Preferred Drug List (PDL) Update, Hepatitis C, Morphine Equivalent Limitations Update, Drug Utilization Review (DUR) Board Update, Attention Outpatient Speech Therapists, Home and Community Based Services (HCBS) Waiver Providers, In-Home Support Services (IHSS), and April and May 2016 Provider Workshops.
04/18/2016 - Correction: The original bulletin incorrectly stated that the rendering NPI number on electronic claims should be entered in the2420F loop. The rendering NPI number should be entered in the 2420A loop.

Medicaid Program News and Updates (B1600380 - 03/16) - This bulletin contains information on ACC Phase II Updates: Procurement Timeline & Behavioral Health Services Reimbursement, New Look Medicaid Cards Coming in March, Discontinued Codes, Tax Season and 1099s, New Medicaid Members are Looking for Providers: Please Update Provider Contact Information Maintained in MMIS, DentaQuest Office Reference Manual (ORM) Update, Billing and Program Update from DentaQuest, Cost Report forms and Instructions for Freestanding FQHCs, Federally Qualified Health Center Managed Care Accuracy Audit Report Forms and Instructions, Imaging Services at Federally Qualified Health Centers, Preferred Drug List (PDL) Update, Morphine Equivalent Limitations Update, Rural Health Center (RHC) Encounter Rate Carve-Out - Long-Acting Reversible Contraceptive (LARC) Device Provision, Attention Outpatient Speech Therapists, Speech Therapy National Correct Coding Initiative Webinar, Community Transition Services (CTS) Rate Increase, Home and Community Based Services (HCBS) Waiver Providers, and March and April 2016 Provider Workshops.

03/08/2016 - Correction: The original bulletin listed two incorrect fee-for-service rates for HCPCS codes J7300 and J7301. The updated bulletin now reflects the correct rates.

Medicaid Program News and Updates (B1600379 - 02/16)- This bulletin contains information on the Accountable Care Collaborative Phase II: Stakeholder Feedback and Meeting Summaries, Person and Family Centered Approach: Creating a Culture of Collaboration with Members, Regulatory Efficiency Review: 8.079 Quality Improvement, ColoradoPAR Process Resources, Tax Season and 1099s, Healthcare Common Procedure Coding System (HCPCS) Updates for 2016 - Current Dental Terminology (CDT) Changes, Billing and Program Updates from DentaQuest, Coverage for Female Condoms and Spermicides, International Classification of Diseases 10th Revision (ICD-10) and Rehabilitation Specialty Hospitals, Pharmacy Dispensing Fees for Calendar Year 2016, Morphine Equivalent Limitations Update, Hepatitis C Medication Prior Authorization Process, Hepatitis C Criteria, Drug Utilization Review Board (DUR) Meeting, Outpatient Speech Therapists, and February and March 2016 Provider Workshops.


2016 Practitioner HCPCS Special Bulletin (B1600378 - 01/16) - This bulletin contains information on 2016 Practitioner HCPCS, including Updates for 2016, Discontinued Codes, Code Description Changes, and New Procedure Codes.


Medicaid Program News and Updates (B1600377 - 01/16) - This bulletin contains information on the Federal Tax Document IRS Form 1095-B Coming in January, Physician Office Data Collection Study, Fiscal Year 2015 Fee-for-Service Depression Screening Summary, 2016 Health Care Procedural Coding System Codes Annual Update, ColoradoPAR, ACC Phase II January 2016, New Desk Aid for Eligibility Notice of Action, Continuous Eligibility FAQ Now Available, Coming in January: Enhancements to PEAKHealth Mobile App, Tax Season and 1099s, January and February 2016 Holidays, Long Acting Reversible Intrauterine Contraceptive Methods: Newly Assigned Healthcare Common Procedure Coding System Codes, Reimbursement for Group Services at FQHCs, New and Updated Immunization Current Procedural Terminology Codes, Medicaid Hospice Reimbursement Effective January 1, 2016, All Patient Refined-Diagnosis Related Group and Immediate Post-Partum Long-Acting Reversible Contraception Update, Durable Medical Equipment, Prosthetics, Orthotics and Supplies, Morphine Equivalent Limitations Update, January Preferred Drug List Announcement, Omega-3-Acid Ethyl Esters for Cardiovascular Protection, Hepatitis C Medication Prior Authorization Process, Prior Authorization Reminder, Psychiatric Consultation for Children, Outpatient Speech Therapists, and Community Transition Services Rate Increase.

02/10/2016 - Correction: The original bulletin listed an incorrect Code Description and Rate in the "Community Transition Services (CTS) Rate Increase" article. The updated bulletin now reflects the correct code and rate.