Substance Use Disorder Services
The Department of Health Care Policy and Financing (the Department) is committed to better health outcomes for the whole person by offering a full range of healthcare services for Health First Colorado (Colorado’s Medicaid program) members. Health First Colorado members get physical health and dental services and are also eligible for behavioral health services, which include substance use disorder (SUD) treatment. Behavioral health services including SUD treatment are available to all members without the need for a referral or copay. Health First Colorado members can find SUD benefit information in the member handbook. Providers looking for more information about offering SUD services can go to the SUD provider page.
The current SUD benefit ensures a full continuum of care as outlined by The American Society of Addiction Medicine (ASAM). ASAM establishes guidelines for what services are available at each level of care. It’s also a uniformed approach to identifying the most appropriate level of care for a member based on their individual needs. The ASAM criteria is a nationally recognized, evidence-based system that guides clinicians with matching patient needs to specific levels of care.
Colorado uses ASAM Criteria to determine Level of Care placement for members. Office of Behavioral Health provider licensing rules align with the ASAM criteria descriptions of each level of care.
| Level of Care | Description |
|---|---|
| Prevention | .5 Early Intervention |
| Level 1 | 1 Outpatient Services |
| Level 2 |
2.1 Intensive Outpatient Services |
| Level 3 |
3.1 Clinically Managed Low-Intensity Services |
| Level 4 | 4 Medically Managed Intensive Inpatient Services |
| Level of Care | Description |
|---|---|
| Prevention | .5 Early Intervention |
| Level 1 | 1 Outpatient Services |
| Level 2 |
2.1 Intensive Outpatient Services |
| Level 3 |
3.1 Clinically Managed Low-Intensity Services |
| Level 4 | 4 Medically Managed Intensive Inpatient Services |
Services ranging from screening and harm reduction to outpatient, intensive outpatient and medication-assisted treatment services to withdrawal management (also known as) "detox" to both residential and hospital inpatient services, are all available treatment options for members. Providers work to find the right level of care that meets the member’s specific needs.
SUD Residential Care in Colorado
Providers are included on the SUD Residential Services Map searchable by level of ASAM care or region, they meet the following criteria:
- Licensed to provide care at a specific ASAM level and
- Enrolled as Health First Providers at that ASAM level
- The Department maintains a full list of SUD providers enrolled in Health First Colorado and contracted with the MCEs.
In addition, the map includes information about which MCEs a provider is contracted with to provide services to members from that region.
CMS 1115 Waiver Documents
- CO SUD Monitoring Protocol Approval Letter
- SUD Evaluation Design Approval Letter
- CO SUD Special Terms and Conditions
- Colorado SUD Implementation Plan Approval and CMS
- CMS Letter of Approval, Expenditure Authority, and the Special Terms and Conditions for 1115 SUD Demonstration Waiver
CMS 1115 Waiver Reports
State Legislative Requirements and Reporting
SUD UTILIZATION MANAGEMENT REPORTS PRODUCED IN ACCORDANCE WITH SB21-137 FOR DEMONSTRATION YEAR 1 OF THE EXPANDED SUD BENEFIT HAVE BEEN ARCHIVED. PLEASE CONTACT THE SUD BENEFIT TEAM BY SUD BENEFITS EMAIL IF YOU NEED A COPY OF THE REPORTS FROM DEMONSTRATION YEAR 1. REPORTS FROM DEMONSTRATION YEAR 2 HAVE BEEN TEMPORARILY TAKEN DOWN TO INCORPORATE CORRECTIONS. PLEASE CONTACT THE SUD BENEFIT TEAM BY EMAIL SUD BENEFITS EMAIL IF YOU NEED INFORMATION FROM THESE REPORTS IMMEDIATELY.
Resources
- Colorado Crisis Services
- Primary Prevention | Overdose Prevention Strategy
- US Department of Health and Human Services Overdose Prevention Strategy | ASPE
- Colorado Department of Law Opioid Crisis Response Project
- Learn More About The Recovery Cards Project
- Mobile Health Units Including SUD Services
- SUD Newsletter Library
Archives
- SUD Residential and Inpatient Benefit Overview
- SUD Residential and Inpatient Benefit FAQs
- SUD Residential Expansion FAQs (July 2020)
- December 2022
- January 2023
Stay Informed
We encourage you to sign up for SUD Benefits updates.
Ask a question or make a suggestion: hcpf_sudbenefits@state.co.us