Department Program Rules and Regulations

To access the text of the Secretary of State's (SOS) official online version of the Department's rules, click on the links below.

Children's Basic Health Plan

10 CCR 2505-3
50 - 600

300 - Enrollment Fees and Co-pays

50 - Definitions400 - Enrollment
100 - Eligibility500 - Financial Management
170 - Presumptive Eligibility600 - Appeals Process
200 - Benefits Package 


Medical Assistance

10 CCR 2505-10
8.000 - 8.0998.061 Use Of Other Resources In The Provision Of Medical Assistance
8.010 Medical Assistance Benefit Coverage Standards8.062 Social Security Medicare Benefits
8.011.1 General Exclusions From Coverage8.063 Medical Assistance Estate Recovery
8.012 Providers Prohibited From Collecting Payment From Recipients8.064 Data Provision and Claims Requirements (Eff. 03/30/2009)
8.013 Out-of-State Medical Care8.065 Recovery of Medical Assistance Overpayments
8.014 Non Emergent Medical Transportation8.066 Health Insurance Buy-In
8.015 Electronic Health Record Incentive Payment Program8.070 Mis-Utilization, Fraud, or Abuse
8.016 Alternative Benefit Plan8.075 Client Over Utilization Program
8.017 Habilitative Services8.076 Program Integrity (Eff. 12/30/2008)
8.040 Recoveries From Providers8.079 Quality Improvement (Eff. 05/30/2009)
8.041 Claims Reimbursement and Status8.080 Medicaid Eligibility Quality Control
8.042 Utilization of a Cash System of Accounting8.090 Medicaid Claims Processing and Third Party Liability Quality Control
8.043 Timely Filing Requirements 
8.049 Reconsideration/Appeal of Adverse Administrative Action 
8.050 Provider Appeals 
8.057 Recipient Appeals 
8.058 Request for Prior Authorization 


8.100 - 8.1998.170 State Identification Number
8.100 Medical Assistance Eligibility8.180 Medical Identification Cards and Duration of Eligibility
8.125 Provider Screening8.190 Acute Medical Benefits Determination
8.130 Provider Participation 


8.200 - 8.2998.212 Community Behavioral Health Services
8.200 Physician Services8.215 Community Mental Health Services Program Capitation Rate Setting
8.201 Dental Services8.220 Competitive Procurement and Selective Contracting, Including Global Fee Payment Programs
8.202 Dental Services for Children8.221 General Provisions
8.203 Vision Services8.280 Early And Periodic Screening, Diagnosis And Treatment (Eff. 10-01-2007)
8.205 Medicaid Managed Care Program8.290 School Health Services
8.209 Medicaid Managed Care Grievance and Appeal Processes8.295 School-Based Health Center Benefit Coverage Standard


8.300 - 8.3998.391 Single Entry Point District Designation
8.300 Hospital Services8.392 Financing of the Single Entry Point System
8.310 Dialysis Treatment Centers8.393 Functions of a Single Entry Point Agency
8.320 Community Clinic and Community Clinic and Emergency Center 
8.390 Long-Term Care Single Entry Point System 


8.400 - 8.499 
8.400 Long-Term Care8.443 Nursing Facility Reimbursement
8.401 Level of Care Screening Guidelines8.444 through 8.446 Repealed, Effective June 30, 2005
8.402 Admission Procedures for Long-Term Care8.448Repealed, Effective May 30, 2006
8.403 Long-Term Care- Services to the Developmentally Disabled8.461Repealed, Effective May 30, 2006
8.404 Admission Criteria: Programs for the Developmentally Disabled8.470 Hospital Back Up Level of Care
8.405 Admission Procedures: Programs for the Developmentally Disabled8.481 Medical Review/Independent Professional Review
8.406 Nursing Facility Care- Levels of Care8.482 Resident Income and Possessions
8.407 Special Provision Concerning Clients Eligible for Social Security Age - 72 Benefits (Prouty)8.483 Adult Foster Care - REPEALED
8.408 Levels of Care Defined - Skilled Nursing Care8.484 Home Care Allowance- REPEALED
8.409 Levels of Care Defined - Intermediate Nursing Care8.485 Home and Community Based Services for the Elderly, Blind and Disabled (HCBS-EBD) General Provisions
8.415 Role of Counties and Nursing Facilities8.486 HCBS-EBD Case Management Functions
8.420 Requirements and Provisions for Participation by Colorado Nursing Facilities8.487 HCBS-EBD Provider Agencies
8.421 Responsibility of County Department Concerning Participation8.488 Electronic Monitoring
8.422 Visits to Recipients by Social Services Personnel, Privacy for Conferences with Recipients8.489 Personal Care
8.423 Visits to Recipients by the Colorado Long-Term Care Ombudsman and Designated Representatives8.490 Homemaker Services
8.424 Periodic Visits- Nursing Home Records to be Made Available8.491 Adult Day Services
8.425 Repealed, Effective June 30, 20058.492 Respite Care
8.430 Medicaid Certification of New Nursing Facilities or Additional Beds8.493 Home Modification
8.435 Enforcement Remedies8.494 Non-Medical Transportation
8.440 Nursing Facility Benefits8.495 Alternative Care Facilities (Eff. 03/30/2009)
8.441 Nursing Facility Cost Reporting8.496 Home and Community Based Services for Persons Living with AIDS (HCBS-PLWA) General Provisions - REPEALED effective March 30, 2014
8.442 Submission of Cost Reporting Information8.497 Program of All-Inclusive Care for the Elderly (PACE)


8.500 - 8.5998.520 Home Health Services
8.500 Home and Community Based Services for the Developmentally Disabled (HCB-DD) Waiver8.525 Services Requirements
8.500.90 Supported Living Services Waiver (SLS)8.535 Pediatric Personal Care Services
8.501 State Funded Supported Living Services Program8.540 Private Duty Nursing Services
8.503 Children's Extensive Support Waiver Program (CES)8.550 Hospice Benefit
8.504 Home and Community Based Services for Children with Life Limiting Illness Waiver8.551 Consumer Directed Attendant Support - REPEALED effective February 1, 2014
8.505 Increase of the Reimbursement Rate Reserved for Compensation of Direct Support Professionals8.552 In-Home Support Services (IHSS)
8.506 Children's Home and Community Based Services Waiver Program8.553 Life Skills Training, Home Delivered Meals, Peer Mentorship, & Transition Setup Services
8.508 Children's Habilitation Residential Program8.555 Colorado Choice Transitions (CCT), A Money Follows the Person Demonstration
8.509 Home and Community Based Services for Community Mental Health Supports(HCBS-CMHS)8.560 Clinic Services- Certified Health Agencies
8.510 Consumer Directed Attendant Support Services (Eff. 12/30/2007)8.570 Ambulatory Surgery Centers
8.515.00 Home and Community Based Services For Persons with Brain Injury (HCBS-BI)8.580 Oxygen And Oxygen Equipment
8.516.10 Independent Living Skills Training8.585 Oxygen, Oxygen Equipment, And Supplies
8.516.30 Transitional Living8.590 Durable Medical Equipment And Disposable Medical Supplies
8.516.40 Behavioral Programming 
8.516.50 Counseling 
8.516.60 Substance Abuse Counseling 
8.516.70 Respite Care 
8.517 Home and Community Based Services Complementary and Integrated Health Waiver (HCBS-CIH) 
8.518 Consumer Directed Care For The Elderly (Repealed Effective 9/30/16) 
8.519 Case Management 


8.600 - 8.699 
8.600 Services for Individuals with Intellectual and Developmental Disabilities8.609 Program Services and Supports
8.601 Administrative Services8.610 Facility Based Adult Day Habilitation Services and Supports
8.602 Service Agencies8.611 Transportation
8.603 Program Approval by the Department8.612 Supports Intensity Scale Assessment and Support Levels
8.604 Due Process and Confidentiality8.613 Family Support Services (FSS) Program
8.605 Dispute Resolution Procedures8.614 Gastrosomy Services
8.606 Confidentiality8.660 Laboratory and X-Ray
8.607Case Management Services 
8.608 Service and Support Planning, Supporting People with Challenging Behavior, and Protections 


8.700 - 8.799 
8.700 Federally Qualified Health Centers8.748 Prenatal Plus Program
8.715 Breast and Cervical Cancer Program8.749 Nurse Home Visitor Program
8.726 Teen Pregnancy Prevention Pilot Program8.750 Community Mental Health Centers/Clinics (Effective August 30, 2007)
8.730 Family Planning Services8.754 Client Co-Pay
8.740 Rural Health Clinics8.760 Targeted Case Management Services
8.745 Special Connections8.765 Services for Clients in Psychiatric Residential Treatment Facilities or Residing in Residential Child Care Facilities
8.746 Outpatient Substance Abuse Treatment8.770 Abortion Services
8.747 Screening, Brief Intervention And Referral to Treatment Services 


8.800 - 8.899 
8.800 Pharmaceuticals8.815 Immunization Services
8.810 Podiatry Services 


8.900 - 8.999 
8.900 Colorado Indigent Care Program (CICP)8.950 Primary Care Fund
8.930 Comprehensive Primary and Preventive Care Grant Program - REPEALED effective August 12, 20118.960 Colorado Dental Health Care Program for Low-Income Seniors
8.940 Old Age Pension Health Care Program 


8.1000 - 8.1099
8.1000 Medicare Modernization Act - Low-Income Subsidy Eligibility


8.2000 Hospital Provider Fee Collection and Disbursement - REPEALED effective October 30, 2017


8.30008.3002 Responsibilities of the Enterprise and Hospitals
8.3000 Healthcare Affordability and Sustainability Fee8.3003 Healthcare Affordability and Sustainability Fee
8.3001 Definitions8.3004 Supplemental Medicaid and Disproportionate Share Hospital Payments