HCBS Provider Specialty Code List

Use the specialty search tool below to learn about the required credentials and documentation for all Home and Community Based Services (HCBS) specialties.

This search tool is designed to assist:

Family members of individuals receiving services who want to become providers
Existing HCBS Health First Colorado (Colorado's Medicaid program) providers who want to expand the types of services they provide
An individual or business who wants to expand the types of services they provide in the community

Provider qualifications questions? Email HCPF_HCBS_Questions@state.co.us

Ready for enrollment? Review the HCBS Provider Enrollment Information Page and the HCBS Provider Enrollment Training

Risk Level - Each specialty is designated as limited, moderate, or high risk.

Limited = meets Federal/State requirements, license/certification verifications, database checks, etc.
Moderate = limited requirements plus a site visit at the service location address
High = moderate requirements and fingerprint criminal background checks

Other Requirements

Fee Required = The specialty indicates if a fee is required by federal or state regulation
NPI Required = The specialty is required to have a National Provider Identifier (NPI)
Tax ID Required = The specialty allows a business using a federal Employer Identification Number (EIN), or an individual using a Social Security Number (SSN)
OOS Allowed = (Out-of-state (OOS) enrollment allowed) The specialty allows for out-of-state service locations
BT Allowed = (Border town (BT) enrollment allowed) The specialty allows the service location to be in an approved border town. See Appendix F for a list of approved border towns.

View Acronym Glossary

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To Search: Enter a search term in the field at the top of a column to narrow the list.

List Updated: July 13, 2023

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Specialty Name and Waiver	Specialty Code	Enrollment Requirements	Revalidation Requirements
Acupuncture - CIH	879	Required Certifications and/or Licenses: Acupuncturist license from Department of Regulatory Agencies (DORA) for each individual providing services. A resume for each individual providing services that demonstrates the following experience: One (1) year of experience providing Acupuncture services at the rate of 520 hours per year. OR One (1) year of experience working with individuals with paralysis or other long-term physical disabilities. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: Yes OOS Allowed: No BT Allowed: No	Required Certifications and/or Licenses: Acupuncturist license from DORA for each individual providing services. A resume for each individual providing services that demonstrates the following experience: One (1) year of experience providing Acupuncture services at the rate of 520 hours per year. OR One (1) year of experience working with individuals with paralysis or other long-term physical disabilities. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: Yes OOS Allowed: No BT Allowed: No
Adpt Therapeutic Recreational Equipment/Fees - CES	600	Required Certifications and/or Licenses: None Risk Level: Limited Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: Yes BT Allowed: Yes	Required Certifications and/or Licenses: None Risk Level: Limited Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: Yes BT Allowed: Yes
Adult Day Services - BI/EBD/CIH/CMHS	601	Required Certifications and/or Licenses: Recommendation for approval from the Colorado Department of Public Health and Environment. The recommendation is not required to be attached to the application. Risk Level: Moderate Tax ID Required: EIN Fee Required: No NPI Required: Yes OOS Allowed: No BT Allowed: No	Required Certifications and/or Licenses: Adult Day Services certification from the Colorado Department of Public Health and Environment. The certification is not required to be attached to the application. Risk Level: Moderate Tax ID Required: EIN Fee Required: No NPI Required: Yes OOS Allowed: No BT Allowed: No
Alternative Care Facility - EBD/CMHS	602	Required Certifications and/or Licenses: Each alternative care facility location must complete a separate application. ACF Training Certificate obtained by completing the ACF New Provider Training module on the HCPF website. Assisted Living Residence License from the Colorado Department of Public Health and Environment And Recommendation for approval from the Colorado Department of Public Health and Environment. The recommendation is not required to be attached to the application. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No	Required Certifications and/or Licenses: Assisted Living Residence License from the Colorado Department of Public Health and Environment And Certification from the Colorado Department of Public Health and Environment. The certification is not required to be attached to the application. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No
Assistive Technology - BI	603	Required Certifications and/or Licenses: In-state presence required for out-of-state providers for installation and service. Risk Level: High Tax ID Required: EIN Fee Required: Yes NPI Required: No OOS Allowed: Yes BT Allowed: Yes	Required Certifications and/or Licenses: In-state presence required for out-of-state providers for installation and service. Risk Level: Moderate Tax ID Required: EIN Fee Required: Yes NPI Required: No OOS Allowed: Yes BT Allowed: Yes
Assistive Technology - CES/SLS	607	Required Certifications and/or Licenses: In-state presence required for out-of-state providers for installation and service. Risk Level: High Tax ID Required: SSN or EIN Fee Required: Yes NPI Required: No OOS Allowed: Yes BT Allowed: No	Required Certifications and/or Licenses: In-state presence required for out-of-state providers for installation and service. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: Yes NPI Required: No OOS Allowed: Yes BT Allowed: No
Behavioral Programming - BI	609	Required Certifications and/or Licenses: Must submit applicable licensure for Program Director to include Licensed Psychologist with demonstrated applicable experience, or LCSW, PT, OT, SLP, RN or Masters level Psychologist with demonstrated applicable experience. Must submit a copy of the license along with a resume, transcript and/or curriculum vitae for review. Electronic Visit Verification is required for some services billed under this specialty code and will be automatically added with an approved application for Health First Colorado (Colorado's Medicaid Program). For additional information visit the EVV web page. Risk Level: Moderate Tax ID Required: EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No	Required Certifications and/or Licenses: Must submit applicable licensure for Program Director to include Licensed Psychologist with demonstrated applicable experience, or LCSW, PT, OT, SLP, RN or Masters level Psychologist with demonstrated applicable experience. Must submit a copy of the license along with a resume, transcript and/or curriculum vitae for review. Risk Level: Moderate Tax ID Required: EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No
Behavioral Services - DD/SLS	610	Required Certifications and/or Licenses: A copy of an approved Program Approved Service Agency (PASA) application from the Colorado Department of Public Health and Environment OR A signed attestation on the provider's letterhead that states the provider is an established PASA. Recommendation for approval from the Colorado Department of Public Health and Environment. The recommendation is not required to be attached to the application. Board Certified Behavioral Analyst (BCBA) Certificate must be submitted or one of the following licenses: Licensed Clinical Social Worker (LCSW) Certified Rehabilitation Counselor Licensed Professional Counselor (LPC) Licensed Clinical Psychologist Licensed Marriage and Family Therapist If any of the above licenses are submitted (excluding BCBA Certificate), the provider must also submit: A resume that demonstrates a minimum of two years of experience in providing counseling to individuals with intellectual and developmental disabilities. Electronic Visit Verification is required for some services billed under this specialty code and will be automatically added with an approved application for Health First Colorado (Colorado's Medicaid Program). For additional information visit the EVV web page. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: Yes BT Allowed: No	Required Certifications and/or Licenses: Certification from the Colorado Department of Public Health and Environment. The certification is not required to be attached to the application. Board Certified Behavioral Analyst (BCBA) Certificate must be submitted or one of the following licenses: Licensed Clinical Social Worker (LCSW) Certified Rehabilitation Counselor Licensed Professional Counselor (LPC) Licensed Clinical Psychologist Licensed Marriage and Family Therapist If any of the above licenses are submitted (excluding BCBA Certificate), the provider must also submit: A resume that demonstrates a minimum of two years of experience in providing counseling to individuals with intellectual and developmental disabilities. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: Yes BT Allowed: No
Benefits Planning DD/SLS	774	Each individual providing services must possess one of the following certificates. However, only one certificate is required to be attached to the application: Community Work Incentives Coordinator (CWIC) from Virginia Commonwealth University Community Partner Work Incentives Counselor (CPWIC) from Virginia Commonwealth University Work Incentive Practitioner from Cornell University Institute on Employment and Disability Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No	Each individual providing services must possess one of the following certificates. However, only one certificate is required to be attached to the revalidation: Community Work Incentives Coordinator (CWIC) from Virginia Commonwealth University Community Partner Work Incentives Counselor (CPWIC) from Virginia Commonwealth University Work Incentive Practitioner from Cornell University Institute on Employment and Disability
Children with LLI – Massage Therapy CLLI	613	Required Certifications and/or Licenses: For both SSN and EIN enrollments a massage license through the Colorado Department of Regulatory Agencies (DORA) is required for each individual performing services. Out-of-state providers must ALSO provide a massage license from their appropriate state agency, along with their Colorado DORA license. Massage Therapy providers shall be in good standing with the Colorado Office of Massage Therapy Licensure. EIN enrollments - Home Care Agency Class A license or Hospice license is optional. Providers enrolling with an EIN must submit a statement on a letterhead attesting that the provider is the only person who will be providing services and that he/she will not be hiring others to provide these services. If the provider will have employees providing services, the provider must submit a list of staff and attach a copy of the current license for each employee. The provider must sign either attestation. Providers enrolling with an SSN do not need to provide an attestation. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: Yes BT Allowed: Yes	Required Certifications and/or Licenses: A massage license through the Colorado Department of Regulatory Agencies (DORA) is required for each individual performing services. Out-of-state providers must ALSO provide a massage license from their appropriate state agency, along with their Colorado DORA license. EIN enrollments - Home Care Agency Class A license or Hospice license is optional. Providers enrolled with an EIN must submit a statement on letterhead attesting that the provider is the only person who is providing services and that he/she will not be hiring others to provide these services. If the provider has employees providing services, the provider must submit a list of staff and attach a copy of the current license for each employee. The provider must sign either attestation. Providers enrolled with an SSN do not need to provide an attestation. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: Yes BT Allowed: Yes
Children with LLI - Palliative/Supportive Care CLLI	614	Required Certifications and/or Licenses: Hospice or Home Care Agency Class A License from the Colorado Department of Public Health and Environment Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: Yes BT Allowed: Yes	Required Certifications and/or Licenses: Hospice or Home Care Agency Class A License from the Colorado Department of Public Health and Environment (attach a copy of current license and complete the license information in revalidation) Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: Yes BT Allowed: Yes
Children with LLI – Respite (Skilled) CLLI	615	Required Certifications and/or Licenses: Hospice or Home Care Agency Class A License from the Colorado Department of Public Health and Environment Electronic Visit Verification is required for some services billed under this specialty code and will be automatically added with an approved application for Health First Colorado (Colorado's Medicaid Program). For additional information visit the EVV web page. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No	Required Certifications and/or Licenses: Hospice or Home Care Agency Class A License from the Colorado Department of Public Health and Environment (attach a copy of current license and complete the license information in revalidation) Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No
Children with LLI – Respite (Unskilled) CLLI	616	Required Certifications and/or Licenses: One of the following licenses issued by the Colorado Department of Public Health and Environment: Home Care Agency Class A license OR Home Care Agency Class A or Class B license AND Personal Care/Homemaker Services certification from CDPHE (certification is not required to be attached to the application) OR Hospice license Electronic Visit Verification is required for some services billed under this specialty code and will be automatically added with an approved application for Health First Colorado (Colorado's Medicaid Program). For additional information visit the EVV web page. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No	Required Certifications and/or Licenses: Attach a copy of a current license and complete the license information in revalidation Home Care Agency Class A license issued by CDPHE OR Home Care Agency Class A or Class B license AND Personal Care/Homemaker Services certification issued by CDPHE (certification is not required to be attached to the application) OR Hospice license issued by CDPHE Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No
Children with LLI – Therapy and Counseling CLLI	617	Required Certifications and/or Licenses: License from the Colorado Department of Regulatory Agencies (DORA) for Licensed Clinical Social Worker, Licensed Professional Counselor, Licensed Social Worker, Licensed Psychologist, Licensed Independent Social Worker, or Music Therapist Board Certification or certification as a non-denominational/Spiritual/Bereavement Counselor/Chaplain if in-state. Licensed Clinical Social Worker, Licensed Professional Counselor, Licensed Social Worker, Licensed Psychologist, Licensed Independent Social Worker, or Music Therapist Board Certification OR certification as a non-denominational/Spiritual/Bereavement Counselor/Chaplain - if out-of-state. For each individual providing services, providers must submit a license and a resume showing individual/family grief, loss, or bereavement counseling with pediatric/adolescent experience of one year. EIN enrollments - Home Care Agency Class A license or Hospice license is optional Providers enrolling with an EIN must submit a statement on letterhead attesting that the provider will be the only person who will be providing services, and that he/she will not be hiring others to provide these services. If the provider will have employees providing services, the provider must submit a list of staff and attach a copy of the current license or certification and resume for each employee. The provider must sign either attestation. Providers enrolling with an SSN do not need to provide an attestation. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: Yes BT Allowed: Yes	Required Certifications and/or Licenses: License from the Colorado Department of Regulatory Agencies (DORA) for Licensed Clinical Social Worker, Licensed Professional Counselor, Licensed Social Worker, Licensed Psychologist, Licensed Independent Social Worker, or Music Therapist Board Certification or certification as a non-denominational/Spiritual/Bereavement Counselor/Chaplain if in-state Licensed Clinical Social Worker, Licensed Professional Counselor, Licensed Social Worker, Licensed Psychologist, Licensed Independent Social Worker, or Music Therapist Board Certification or certification as a non-denominational/Spiritual/Bereavement Counselor/Chaplain - if out-of-state Providers enrolled with an EIN must submit a statement on letterhead attesting that the provider is the only person who will be providing services and that he/she will not be hiring others to provide these services. If the provider will have employees providing services, the provider must submit a list of staff and attach a copy of the current license for each employee. The provider must sign either attestation. Sole proprietors enrolling with an SSN do not need to provide an attestation. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: Yes BT Allowed: Yes
Children’s Case Management - CHCBS	618	A Bachelor's Degree in any field; OR Resume demonstrating five (5) years of experience in the field of Long-Term Services and Supports (LTSS), which includes Developmental Disabilities; OR Some combination of education and relevant experience appropriate to the requirements of the position demonstrated on a resume. Relevant experience is defined as: a. Experience in one of the following areas: long-term care services and supports, gerontology, physical rehabilitation, disability services, children with special health care needs, behavioral science, special education, public health or non-profit administration, or health/medical services, including working directly with persons with physical, intellectual or developmental disabilities, mental illness, or other vulnerable populations as appropriate to the position being filled; AND completed coursework and/or experience related to the type of administrative duties performed by case managers may qualify for up to two (2) years of required relevant experience. Risk Level: Moderate Tax ID Required: EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No	A Bachelor's Degree in any field; OR Resume demonstrating five (5) years of experience in the field of Long-Term Services and Supports (LTSS), which includes Developmental Disabilities; OR Some combination of education and relevant experience appropriate to the requirements of the position demonstrated on a resume. Relevant experience is defined as: a. Experience in one of the following areas: long-term care services and supports, gerontology, physical rehabilitation, disability services, children with special health care needs, behavioral science, special education, public health or non-profit administration, or health/medical services, including working directly with persons with physical, intellectual or developmental disabilities, mental illness, or other vulnerable populations as appropriate to the position being filled; AND completed coursework and/or experience related to the type of administrative duties performed by case managers may qualify for up to two (2) years of required relevant experience. Risk Level: Moderate Tax ID Required: EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No
Children's Habilitation Residential Program (CHRP)	619	This HCBS Waiver Specialty ended November 1, 2022, and is no longer available for new enrollments or to be added with a maintenance update. Services may be provided by selecting a different CHRP specialty.	Required licensure and/or certification is dependent upon the type of CHRP service provided. HCPF will contact providers once applications are in State Review.
CHRP - Child and Youth Mentorship	882	Required Certifications and/or Licenses: 40 hours of Crisis Prevention, De-escalation, and Intervention training for one Direct Support Professional providing services. Please attach training certificates to the enrollment application AND For the same Direct Support Professional, please attach their High School Diploma or equivalency degree to the enrollment application. Optional: Businesses/Entities in possession of the following credentials must submit a current license: Residential Child Care Facility/Qualified Residential Treatment Program license from the Colorado Department of Human Services Child Care License for a Child Placement Agency from the Colorado Department of Human Services. Risk Level: Moderate Tax ID Required: EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No	Required Certifications and/or Licenses: Optional: Businesses/Entities in possession of the following credentials must submit a current license: Residential Child Care Facility/Qualified Residential Treatment Program license from the Colorado Department of Human Services Child Care License for a Child Placement Agency from the Colorado Department of Human Services. Risk Level: Moderate Tax ID Required: EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No
CHRP - Community Connector	883	Required Certifications and/or Licenses: One of the following requirements: Child Care License for a Child Placement Agency from the Colorado Department of Human Services OR Currently enrolled as a Specialty 634 Community Connector CES provider. Risk Level: Moderate Tax ID Required: EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: Yes	Required Certifications and/or Licenses: One of the following requirements: Child Care License for a Child Placement Agency from the Colorado Department of Human Services OR Currently enrolled as a Specialty 634 Community Connector CES provider. Risk Level: Moderate Tax ID Required: EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: Yes
CHRP - Habilitation	884	Required Certifications and/or Licenses: Please submit one of the following licenses or certifications: Foster Care certification or Kinship Foster Care Certification from a County Department or Child Placement Agency Residential Child Care Facility/Qualified Residential Treatment Program license from the Colorado Department of Human Services Child Care license for a Child Placement Agency license from the Colorado Department Human Services Child Care license for Group Home or Group Center from the Colorado Department of Human Services Recommendation of approval from the Colorado Department of Public Health and Environment to provide specialty 674 Residential Habilitation Services IRSS/Host Home. Residential Habilitation Services IRSS/Host Home providers must submit a signed attestation on letterhead that states the provider will only provide CHRP Habilitation services to members 18 and older. County Departments please email HCPF_CHRP@state.co.us prior to submitting an application. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No	Required Certifications and/or Licenses: Please submit one of the following licenses or certifications: Foster Care certification or Kinship Foster Care Certification from a County Department or Child Placement Agency Residential Child Care Facility/Qualified Residential Treatment Program license from the Colorado Department of Human Services Child Care license for a Child Placement Agency license from the Colorado Department Human Services Child Care license for Group Home or Group Center from the Colorado Department of Human Services Recommendation of approval from the Colorado Department of Public Health and Environment to provide specialty 674 Residential Habilitation Services IRSS/Host Home. Residential Habilitation Services IRSS/Host Home providers must submit a signed attestation on letterhead that states the provider will only provide CHRP Habilitation services to members 18 and older. County Departments please email HCPF_CHRP@state.co.us prior to submitting an application. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No
CHRP - Hippotherapy	741	Required Certifications and/or Licenses: Recommendation for approval from the Colorado Department of Public Health and Environment to provide Specialty 670 Professional Services Hippotherapy CES/SLS. The recommendation is not required to be attached to the application. Risk Level: Moderate Tax ID Required: EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: Yes	Required Certifications and/or Licenses: Currently enrolled as a Specialty 670 Professional Services Hippotherapy CES/SLS Risk Level: Moderate Tax ID Required: EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: Yes
CHRP - Massage Therapy	742	Required Certifications and/or Licenses: Recommendation of approval from the Colorado Department of Public Health and Environment to provide Specialty 729 Professional Services Massage CES/SLS. The recommendation is not required to be attached to the application. Risk Level: Moderate Tax ID Required: EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No	Required Certifications and/or Licenses: Currently enrolled as a Specialty 729 Professional Services Massage CES/SLS Risk Level: Moderate Tax ID Required: EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No
CHRP - Movement Therapy	743	Required Certifications and/or Licenses: Recommendation of approval from the Colorado Department of Public Health and Environment to provide Specialty 672 Movement Therapy CES/SLS. The recommendation is not required to be attached to the application. Risk Level: Moderate Tax ID Required: EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: Yes	Required Certifications and/or Licenses: Currently enrolled as a Specialty 672 Movement Therapy CES/SLS Risk Level: Moderate Tax ID Required: EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: Yes
CHRP - Respite	885	Required Certifications and/or Licenses: Please submit one of the following licenses or certifications: Foster Care certification or Kinship Foster Care Certification from a County Department or Child Placement Agency Residential Child Care Facility/Qualified Residential Treatment Program license from the Colorado Department of Human Services Child Care license for a Child Placement Agency license from the Colorado Department Human Services Child Care license for Group Home or Group Center from the Colorado Department of Human Services Recommendation of approval from the Colorado Department of Public Health and Environment to provide Specialty 676 Respite CES/SLS and a Home Care Agency Class A or Class B license – if applicable. County Departments please email HCPF_CHRP@state.co.us prior to submitting an application. Electronic Visit Verification is required for some services billed under this specialty code and will be automatically added with an approved application for Health First Colorado (Colorado's Medicaid Program). For additional information visit the EVV web page. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No	Required Certifications and/or Licenses: Please submit one of the following licenses or certifications: Foster Care certification or Kinship Foster Care Certification from a County Department or Child Placement Agency Residential Child Care Facility/Qualified Residential Treatment Program license from the Colorado Department of Human Services Child Care license for a Child Placement Agency license from the Colorado Department Human Services Child Care license for Group Home or Group Center from the Colorado Department of Human Services Currently enrolled as a Specialty 676 Respite CES/SLS provider. County Departments please email HCPF_CHRP@state.co.us prior to submitting an application. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No
CHRP-Wraparound	886	Required Certifications and/or Licenses: Businesses (EIN enrollment only) Introduction to High-Fidelity Wraparound Certificate AND Certification in a Wraparound Training Program If a provider is in progress to obtain this certification, a signed attestation on letterhead must be submitted that states the provider is in progress to obtaining certification. Please include the Wraparound Coach’s information on the attestation. AND Bachelor's Degree in a human behavioral science or related field of study OR resume that demonstrates experience working with Long-Term Services and Supports (LTSS) populations, in a private or public social services agency may substitute for the required education on a year for year basis. When using a combination of experience and education to qualify, the education must have a strong emphasis in a human behavioral science field. Optional: Businesses/Entities in possession of the following credentials must submit a current license: Residential Child Care Facility/Qualified Residential Treatment Program license from the Colorado Department of Human Services Child Care License for a Child Placement Agency from the Colorado Department of Human Services. Risk Level: Moderate Tax ID Required: EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No	Required Certifications and/or Licenses: Businesses (EIN enrollment only) Introduction to High-Fidelity Wraparound Certificate AND Certification in a Wraparound Training Program If a provider is in progress to obtain this certification, a signed attestation on letterhead must be submitted that states the provider is in progress to obtaining certification. Please include the Wraparound Coach’s information on the attestation. AND Bachelor's Degree in a human behavioral science or related field of study OR resume that demonstrates experience working with Long-Term Services and Supports (LTSS) populations, in a private or public social services agency may substitute for the required education on a year for year basis. When using a combination of experience and education to qualify, the education must have a strong emphasis in a human behavioral science field. Optional: Businesses/Entities in possession of the following credentials must submit a current license: Residential Child Care Facility/Qualified Residential Treatment Program license from the Colorado Department of Human Services Child Care License for a Child Placement Agency from the Colorado Department of Human Services. Risk Level: Moderate Tax ID Required: EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No
Chiropractic - CIH	880	Required Certifications and/or Licenses: A DORA Chiropractic license for each individual providing services. A resume for each individual providing services that demonstrates the following experience: One (1) year of experience providing Chiropractic services at the rate of 520 hours per year. OR One (1) year experience working with individuals with paralysis or other long-term physical disabilities. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: Yes OOS Allowed: No BT Allowed: No	Required Certifications and/or Licenses: A DORA Chiropractic license for each individual providing services. A resume for each individual providing services that demonstrates the following experience: One (1) year of experience providing Chiropractic services at the rate of 520 hours per year. OR One (1) year experience working with individuals with paralysis or other long-term physical disabilities. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: Yes OOS Allowed: No BT Allowed: No
Community Connector - CES	634	Required Certifications and/or Licenses: A copy of an approved Program Approved Service Agency (PASA) application from the Colorado Department of Public Health and Environment OR A signed attestation on the provider's letterhead that states the provider is an established PASA. Recommendation for approval from the Colorado Department of Public Health and Environment. The recommendation is not required to be attached to the application. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No	Required Certifications and/or Licenses: Certification from the Colorado Department of Public Health and Environment. The certification is not required to be attached to the application. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No
Community Mental Health Services - BI	635	Required Certifications and/or Licenses: License from the Colorado Department of Regulatory Agencies (DORA) for Licensed Professional Counselor (LPC), Licensed Clinical Social Worker (LCSW), Licensed Clinical Psychologist, or Certified Rehabilitation Counselor. Curriculum Vitae or resume for Master's or Doctoral level counselor, outlining two years of mental health counseling experience and education. Providers enrolling with an EIN must submit a statement on letterhead attesting that the provider is the only person who will be providing services and that he/she will not be hiring others to provide these services. If the provider will have employees providing services, the provider must submit a list of staff and attach a copy of the current license or certification and resume for each employee. The provider must sign either attestation. Providers enrolling with an SSN do not need to provide an attestation. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No	Required Certifications and/or Licenses: License from the Colorado Department of Regulatory Agencies (DORA) for Licensed Professional Counselor (LPC), Licensed Clinical Social Worker (LCSW), Licensed Clinical Psychologist, or Certified Rehabilitation Counselor. Curriculum Vitae or resume for Master's or Doctoral level counselor, outlining two years of mental health counseling experience and education. Providers enrolling with an EIN must submit a statement on letterhead attesting that the provider is the only person who will be providing services and that he/she will not be hiring others to provide these services. If the provider will have employees providing services, the provider must submit a list of staff and attach a copy of the current license or certification and resume for each employee. The provider must sign either attestation. Providers enrolling with an SSN do not need to provide an attestation. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No
Day Habilitation Specialized Habilitation - DD/SLS	639	Required Certifications and/or Licenses: A copy of an approved Program Approved Service Agency (PASA) application from the Colorado Department of Public Health and Environment OR A signed attestation on the provider's letterhead that states the provider is an established PASA. Recommendation for approval from the Colorado Department of Public Health and Environment. The recommendation is not required to be attached to the application. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: Yes OOS Allowed: No BT Allowed: No	Required Certifications and/or Licenses: Certification from the Colorado Department of Public Health and Environment. The certification is not required to be attached to the application. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: Yes OOS Allowed: No BT Allowed: No
Day Habilitation Supported Comm Conn - DD/SLS	713	Required Certifications and/or Licenses: A copy of an approved Program Approved Service Agency (PASA) application from the Colorado Department of Public Health and Environment OR A signed attestation on the provider's letterhead that states the provider is an established PASA. Recommendation for approval from the Colorado Department of Public Health and Environment. The recommendation is not required to be attached to the application. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No	Required Certifications and/or Licenses: Certification from the Colorado Department of Public Health and Environment. The certification is not required to be attached to the application. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No
Day Treatment - BI	641	Required Certifications and/or Licenses: Recommendation of approval from the Colorado Department of Public Health and Environment. The recommendation is not required to be attached to the application. Risk Level: Moderate Tax ID Required: EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No	Required Certifications and/or Licenses: Certification from the Colorado Department of Public Health and Environment. The certification is not required to be attached to the application. Risk Level: Moderate Tax ID Required: EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No
Dental Services - DD-SLS (Basic and Major)	749	Special Instructions: If you are a dental provider who provides DIDD dental services you do not need to enroll as more than one provider type. You will enroll as a dental provider and submit your claims to DentaQuest for processing for both services.
Electronic Monitoring - BI/EBD/CIH/CMHS	643	Required Certifications and/or Licenses: In-state presence required for out-of-state providers for installation and service. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: Yes BT Allowed: Yes	Required Certifications and/or Licenses: In-state presence required for out-of-state providers for installation and service. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: Yes BT Allowed: Yes
Expressive Therapy – Art/Play CLLI	645	Required Certifications and/or Licenses: For EIN Enrollments, a Home Care Agency Class A license or Hospice license is optional. License from the Colorado Department of Regulatory Agencies (DORA) for Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Social Worker (LSW), Licensed Independent Social Worker (LISW), or Licensed Psychologist (own state's license) AND resume showing one year of experience in the provision of art/play therapy to pediatric/adolescent clients OR Non-denominational/spiritual/bereavement counselor/chaplain certification AND resume showing one year of experience in the provision of art/play therapy to pediatric/adolescent clients. Providers enrolling with an EIN must submit a statement on letterhead attesting that the provider is the only person who will be providing services and that he/she will not be hiring others to provide these services. If the provider will have employees providing services, the provider must submit a list of staff and attach a copy of the current license or certification and resume for each employee. The provider must sign either attestation. Providers enrolling with an SSN do not need to provide an attestation. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: Yes OOS Allowed: Yes BT Allowed: Yes	Required Certifications and/or Licenses: License (attach a copy of current license and complete the license information in revalidation) License from the Colorado Department of Regulatory Agencies (DORA) for Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Social Worker (LSW), Licensed Independent Social Worker (LISW), or Licensed Psychologist AND resume showing one year of experience in the provision of art/play therapy to pediatric/adolescent clients OR Non-denominational/spiritual/bereavement counselor/chaplain certification AND resume showing one year of experience in the provision of art/play therapy to pediatric/adolescent clients. Providers enrolled with an EIN must submit a statement on letterhead attesting that the provider is the only person who provides services and that he/she will not be hiring others to provide these services. If the provider has employees providing services, the provider must submit a list of staff and attach a copy of the current license or certification and resume for each employee. The provider must sign either attestation. Providers enrolled with an SSN do not need to provide an attestation. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: Yes OOS Allowed: Yes BT Allowed: Yes
Expressive Therapy – Music Therapy CLLI	646	Required Certifications and/or Licenses: A Bachelor's, Master's, or Doctorate in Music Therapy for each individual providing services. Certification from the Certification Board for Music Therapists for each individual providing services. A resume that demonstrates at least one year of experience in the provision of music therapy to pediatric/adolescent clients for each individual providing services. Providers enrolling with an EIN must submit a statement on letterhead attesting that the provider is the only person who will be providing services and that he/she will not be hiring others to provide these services. If the provider will have employees providing services, the provider must submit a list of staff and attach a copy of the current certification, degree, and resume for each employee. The provider must sign either attestation. Providers enrolling with an SSN do not need to provide an attestation. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: Yes OOS Allowed: Yes BT Allowed: Yes	Required Certifications and/or Licenses: Certification from the Certification Board for Music Therapists for each individual providing services. A Bachelor's, Master's or Doctorate in Music Therapy for each individual providing services. Providers enrolled with an EIN must submit a statement on letterhead attesting that the provider is the only person who provides services and that he/she will not be hiring others to provide these services. If the provider has employees providing services, the provider must submit a list of staff and attach a copy of the current certification for each employee. The provider must sign either attestation. Providers enrolled with an SSN do not need to provide an attestation. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: Yes OOS Allowed: Yes BT Allowed: Yes
FMS/Cnsmr Drct Atndnt Sprt Svc BI/EBD/CMHS/CIH/SLS	702	Required Certifications and/or Licenses: None Risk Level: Limited Tax ID Required: EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: Yes	Required Certifications and/or Licenses: None Risk Level: Limited Tax ID Required: EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: Yes
Home Accessibility Adaptations - CES/SLS	648	Required Certifications and/or Licenses: A list of counties/cities served must be attached to the application. For each county/city, please attach one of the following: Contractor's License for counties/cities served If the Contractor's license name and address do not match the enrollment application information, please attach a signed attestation on letterhead that states the name on the Contractor's license is an employee or contractor of the enrolling provider. OR If services do not require a Contractor's license, please attach a signed attestation on letterhead that states services provided do not require a Contractor's license OR If services are provided in a county/city that does not require a Contractor's license, please attach a signed attestation on letterhead that states the county/city served does not require a Contractor's license. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No	Required Certifications and/or Licenses: A list of counties/cities served must be attached to the application. For each county/city, please attach one of the following: Contractor's License for counties/cities served If the Contractor's license name and address do not match the enrollment application information, please attach a signed attestation on letterhead that states the name on the Contractor's license is an employee or contractor of the enrolling provider. OR If services do not require a Contractor's license, please attach a signed attestation on letterhead that states services provided do not require a Contractor's license OR If services are provided in a county/city that does not require a Contractor's license, please attach a signed attestation on letterhead that states the county/city served does not require a Contractor's license. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: No OOS Allowed: No BT Allowed: No
Home Delivered Meals - BI/CMHS/EBD/CIH/DD/SLS	752	Required Certifications and/or Licenses: In-state providers must possess a current license to operate a retail food establishment, issued by the Colorado Department of Public Health and Environment. (Attach a copy of the current license and complete the license information.) Out-of-State providers must attach a signed attestation, on letterhead, that states the provider is enrolled in their own state's Medicaid Program as a meals provider. Risk Level: Moderate Tax ID Required: EIN Fee Required: No NPI Required: Yes OOS Allowed: Yes BT Allowed: Yes	Required Certifications and/or Licenses: In-state providers must possess a current license to operate a retail food establishment, issued by the Colorado Department of Public Health and Environment. (Attach a copy of the current license and complete the license information.) Out-of-State providers must attach a signed attestation, on letterhead, that states the provider is enrolled in their own state's Medicaid Program as a meals provider. Risk Level: Moderate Tax ID Required: EIN Fee Required: No NPI Required: Yes OOS Allowed: Yes BT Allowed: Yes
Home Modification Adaptations - BI, EBD, CIH, CMHS	651	Required Certifications and/or Licenses: A list of counties/cities served must be attached to the application. For each county/city, please attach one of the following: Contractor's License for counties/cities served If the Contractor's license name and address do not match the enrollment application information, please attach a signed attestation on letterhead that states the name on the Contractor's license is an employee or contractor of the enrolling provider. OR If services do not require a Contractor's license, please attach a signed attestation on letterhead that states services provided do not require a Contractor's license OR If services are provided in a county/city that does not require a Contractor's license, please attach a signed attestation on letterhead that states the county/city served does not require a Contractor's license. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: Yes OOS Allowed: No BT Allowed: No	Required Certifications and/or Licenses: A list of counties/cities served must be attached to the application. For each county/city, please attach one of the following: Contractor's License for counties/cities served If the Contractor's license name and address do not match the enrollment application information, please attach a signed attestation on letterhead that states the name on the Contractor's license is an employee or contractor of the enrolling provider. OR If services do not require a Contractor's license, please attach a signed attestation on letterhead that states services provided do not require a Contractor's license. OR If services are provided in a county/city that does not require a Contractor's license, please attach a signed attestation on letterhead that states the county/city served does not require a Contractor's license. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: No NPI Required: Yes OOS Allowed: No BT Allowed: No
Homemaker - CES/SLS	652	Required Certifications and/or Licenses: Recommendation of approval from the Colorado Department of Public Health and Environment. The recommendation is not required to be attached to the application. Electronic Visit Verification is required for some services billed under this specialty code and will be automatically added with an approved application for Health First Colorado (Colorado's Medicaid Program). For additional information visit the EVV web page. Risk Level: High Tax ID Required: SSN or EIN Fee Required: Yes NPI Required: Yes OOS Allowed: No BT Allowed: No	Required Certifications and/or Licenses: Certification from the Colorado Department of Public Health and Environment. The certification is not required to be attached to the application. Risk Level: Moderate Tax ID Required: SSN or EIN Fee Required: Yes NPI Required: Yes OOS Allowed: No BT Allowed: No
In-Home Support Services - EBD/CIH/CHCBS	656	Required Certifications and/or Licenses: Home Care Agency Class A or Class B license from the Colorado Department of Public Health and Environment Recommendation for approval from the Colorado Department of Public Health and Environment. The recommendation is not required to be attached to the application. IHSS Provider Training certificate must be submitted for current and prospective In-Home Support Services (IHSS) Agencies. Training is provided through Consumer Direct for Colorado (CDCO) via hosted webinar, and is required for the agency administrators and back-up administrators annually. For more information and to register for IHSS Provider Training, please visit the CDCO website. Department contact: Emily Harvey Provider must also be approved for specialty 666 - Personal Care/Homemaker Services. Electronic Visit Verification is required for some services billed under this specialty code and will be automatically added with an approved application for Health First Colorado (Colorado's Medicaid Program). For additional information visit the EVV web page. Risk Level: High Tax ID Required: EIN Fee Required: Yes NPI Required: Yes OOS Allowed: No BT Allowed: No"	Required Certifications and/or Licenses: Home Care Agency Class A or Class B license from the Colorado Department of Public Health and Environment (attach a copy of current license and complete the license information in revalidation) Certification from the Colorado Department of Public Health and Environment. The certification is not required to be attached to the application. IHSS Provider Training certificate must be submitted for current and prospective In-Home Support Services (IHSS) Agencies. Training is provided through Consumer Direct for Colorado (CDCO) via hosted webinar, and is required for the agency administrators and back-up administrators annually. For more information and to register for IHSS Provider Training, please visit the CDCO website. Department contact: Emily Harvey Risk Level: Moderate Tax ID Required: EIN Fee Required: Yes NPI Required: Yes OOS Allowed: No BT Allowed: No