Fee For Service Rate Information

Information about any and all rate changes impacting State Plan, Home and Community Based Services (HCBS), and all other Fee for Service rates are detailed by service in the following sections. For questions about rates or fee schedules, please contact Victoria Martinez

Annual Rate Updates Information and Resources

Fiscal Year 2023-2024 Provider Rate Adjustments

Health First Colorado (Colorado's Medicaid Program) across-the-board provider rate increases were approved during the 2022 legislative session and are effective for dates of service beginning July 1, 2023. All rate adjustments are subject to CMS (Centers for Medicare and Medicaid Services) approval prior to implementation. The fee schedules located on the Provider Rates and Fee Schedule web page have been updated to reflect the approved 3.0% across-the-board (ATB) rate increases. Rates have been updated in the Colorado interChange.

Targeted rate rebalances will also be effective as of July 1, 2023. Services approved for a targeted rate adjustment include the following:

  • Cardiology services
  • Cognitive Capabilities services
  • Ear, Nose and Throat services
  • Gastroenterology services
  • Health Education services
  • Ophthalmology services
  • Primary Care and Evaluation and Management services
  • Radiology services
  • Respiratory services
  • Vaccine and Immunization services
  • Vascular services
  • Women’s Health and Family Planning Services
  • Other Physician services
  • Laboratory and Pathology services
  • Vision services
  • Injections and Miscellaneous J Codes
  • Dialysis Non-Facility services

The 3.0% across the board increase for Home and Community Based Services (HCBS) waivers services does not require CMS approval. Claims with dates of service on or after July 1, 2023, will be reimbursed at an increased rate for providers for the following waivers:

  • HCBS - Brain Injury (BI)
  • HCBS - Children’s Extensive Supports (CES)
  • HCBS - Children’s Home and Community Based Service (CHCBS)
  • HCBS - Children with Life Limiting Illness (CLLI)
  • HCBS – Children’s Residential Habilitation Program (CHRP)
  • HCBS - Community Mental Health Supports (CMHS)
  • HCBS - Developmental Disability (DD)
  • HCBS - Elderly, Blind and Disabled (EBD)
  • HCBS - Spinal Cord Injury (SCI)
  • HCBS - Supported Living Services (SLS)

Targeted rate increases will be effective for the following HCBS services, effective July 1, 2023:

  • Adult Day Services, Basic and Specialized- Denver and Non-Denver county
  • Alternative Care Facility- Denver and Non-Denver county
  • Consumer Directed Attendant Support Services, Health Maintenance, Homemaker, and Personal Care (IDD and non-IDD)- Denver and Non-Denver county
  • Specialized Habilitation- Denver and Non-Denver county
  • Supported Community Connections- Denver and Non-Denver county
  • Homemaker Services- Denver and Non-Denver county
  • In Home Support Services, Health Maintenance, Homemaker and Personal Care- Denver and Non-Denver county
  • Peer Mentorship- Non-Denver county
  • Community Connector- Denver
  • Non-Medical Transportation (DD and SLS Waivers)- Denver and Non-Denver county
  • Non-Medical Transportation, Mobility and Wheelchair Van- Denver and Non-Denver county
  • Personal Care services- Denver and Non-Denver county
  • Prevocational Services- Denver and Non-Denver county
  • Residential Habilitation, All Categories Level 1-6- Denver and Non-Denver county
  • Respite Services, All Categories- Denver and Non-Denver county
  • Job Coaching services- Denver and Non-Denver county
  • Brain Injury Supported Living Program- Denver and Non-Denver county
  • Brain Injury Transitional Living Program- Denver and Non-Denver county

The Department will continue to publish updates as they become effective.