Colorado NPI Law

HB 18-1282 requires newly enrolling and currently enrolled organization health care providers (not individuals) to obtain and use a unique National Provider Identifier (NPI) for each service location and provider type enrolled in the Colorado interChange.

The Department of Health Care Policy & Financing (the Department) is responsible for implementing Section 3 of HB 18-1282, which added 25.5-4-419 to the Colorado Revised Statutes. The Department's regulations are not related to Section 2 of HB 18-1282, and can only answer questions related to our regulations implementing Section 3 of HB 18-1282.

Providers who bill Medicare need to ensure each NPI for Health First Colorado is also enrolled with Medicare.

  • Visit the Medicare Enrollment Application web page if a provider needs to add a new NPI to an existing Medicare enrollment. The CMS-855 applications specific to organizations are the 855A and 855B forms. Section 4 of each of these applications is where a provider can add an NPI.
  • What effective date would be assigned to a new NPI added in Provider Enrollment, Chain, and Ownership System (PECOS)? Since the NPI is being added to an existing enrollment there would be no change in the provider's Medicare effective date.
  • Will a new Medicare ID be assigned with the new NPI? The Medicare ID would stay the same.

Visit the Provider News web page for bulletins, newsletters, emails and other communications. Visit the Revalidation web page for revalidation information. Refer to the Provider Maintenance - Adding an NPI Quick Guide located on the Quick Guides web page for information on adding a new NPI.

Contact the Provider Services Call Center with questions regarding the Colorado NPI Law.

 
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