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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

Specialty Name and Waiver

Specialty Code

Enrollment Requirements

Revalidation  Requirements

Acupuncture - CIH879

Required Certifications and/or Licenses:

  • Acupuncturist license from Department of Regulatory Agencies (DORA) for each individual providing services.
     
  • A signed attestation, on letterhead, that each individual providing services demonstrates the following experience:
    • One (1) year of experience providing Acupuncture 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:

  • Acupuncturist license from DORA for each individual providing services.
     
  • A signed attestation, on letterhead, that each individual providing services demonstrates the following experience:
     
    • One (1) year of experience providing Acupuncture 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

Adpt Therapeutic Recreational Equipment/Fees - CES600

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/CMHS601

Required Certifications and/or Licenses:

  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.

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/CMHS602

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
     
  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.

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 - BI603

Required Certifications and/or Licenses:

  • In and out of state providers must attach policies and procedures ensuring:
    • Member rights, privacy and HIPAA compliance;
    • Devices are properly installed; and
    • Timely and person-centered training and customer services for members on the use of devices.

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 and out of state providers must attach policies and procedures ensuring:
    • Member rights, privacy and HIPAA compliance;
    • Devices are properly installed; and
    • Timely and person-centered training and customer services for members on the use of devices.

Risk Level: Moderate
Tax ID Required: EIN
Fee Required: Yes
NPI Required: No
OOS Allowed: Yes
BT Allowed: Yes

Assistive Technology - CES/SLS607

Required Certifications and/or Licenses:

  • In and out of state providers must attach policies and procedures ensuring:
    • Member rights, privacy and HIPAA compliance;
    • Devices are properly installed; and
    • Timely and person-centered training and customer services for members on the use of devices.

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 and out of state providers must attach policies and procedures ensuring:
    • Member rights, privacy and HIPAA compliance;
    • Devices are properly installed; and
    • Timely and person-centered training and customer services for members on the use of devices.

Risk Level: Moderate
Tax ID Required: SSN or EIN
Fee Required: Yes
NPI Required: No
OOS Allowed: Yes
BT Allowed: No

Behavioral Programming - BI609

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/SLS610

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.
     
  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.
  • 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/SLS774

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 CLLI613

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 CLLI614

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

Skilled Respite  - CES/CHRP/CLLI615

Required Certifications and/or Licenses:

  • Hospice or Home Care Agency Class A License from the Colorado Department of Public Health and Environment
  • Respite CES/SLS Certification (C&T) from the Colorado Department of Public Health and Environment. Providers must also enroll in Specialty 676 Respite CES/SLS. 
    • A Home Care Agency Class B license may be accepted in lieu of a Hospice or Home Care Agency Class A license if determined by CDPHE during the Respite CES/SLS certification process.
  • 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. A Home Care Agency Class B license may be accepted for revalidation in lieu of a Hospice or Home Care Agency Class A license if determined by CDPHE during the Respite CES/SLS certification process.  (attach a copy of current license and complete the license information in revalidation)
  • Respite CES/SLS Certification (C&T) from the Colorado Department of Public Health and Environment. Certification (C&T) is not required to be attached to the revalidation application.
  • Providers must also be enrolled in Specialty 676 Respite CES/SLS.

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) CLLI616

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 CLLI617

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 - CHCBS618
  • 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)619This 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 Youth Mentorship-CES/CHRP Therapeutic Respite

882

Child and Youth Mentorship CHRP Providers

  • 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.

Therapeutic/Respite CES/CHRP Providers

Required Certifications and/or Licenses:

  • Respite CES/SLS Certification (C&T) from the Colorado Department of Public Health and Environment. Providers must also enroll in Specialty 676 Respite CES/SLS.
  • 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

Child and Youth Mentorship CHRP Providers

  • none

Therapeutic/Respite CES/CHRP Providers

Required Certifications and/or Licenses:

  • Respite CES/SLS Certification (C&T) from the Colorado Department of Public Health and Environment. Certification (C&T) is not required to be attached to the revalidation application.
  • Providers must also be enrolled in Specialty 676 Respite CES/SLS.
  • 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 Connector883

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 - Habilitation884

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
  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment (CDPHE) to provide Specialty 674 Residential Habilitation Services IRSS/Host Home DD. Providers currently enrolled in Specialty 674 Residential Habilitation Services IRSS/Host Home DD are not required to attach their CDPHE certificate to the application.
  • 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:

  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment (CDPHE) to provide Specialty 670 Professional Services – Hippotherapy CES/SLS. Providers currently enrolled in Specialty 670 Professional Services - Hippotherapy CES/SLS are not required to attach their CDPHE certificate 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:

  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment (CDPHE) to provide Specialty 729 Professional Services - Massage Therapy CES/SLS. Providers currently enrolled in Specialty 729 Professional Services - Massage Therapy CES/SLS are not required to attach their CDPHE certificate 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:

Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment (CDPHE) to provide Specialty 672 Professional Services - Movement Therapy CES/SLS. Providers currently enrolled in Specialty 672 Professional Services - Movement Therapy CES/SLS are not required to attach their CDPHE certificate 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
  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment (CDPHE) to provide Specialty 676 Respite CES/SLS services. Providers currently enrolled in Specialty 676 Respite CES/SLS are not required to attach their CDPHE certificate to the application.

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-Wraparound886

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 - CIH880

Required Certifications and/or Licenses:

  • A DORA Chiropractic license for each individual providing services.
  • A signed attestation, on letterhead, that each individual providing services 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 signed attestation, on letterhead, that each individual providing services 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 - CES634

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.
     
  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.

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 - BI635

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/SLS639

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.
  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.

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/SLS713

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.
  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.

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:

Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.

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 and out of state providers must attach policies and procedures ensuring:
    • Member rights, privacy and HIPAA compliance;
    • Devices are properly installed; and
    • Timely and person-centered training and customer services for members on the use of devices.

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 and out of state providers must attach policies and procedures ensuring:
    • Member rights, privacy and HIPAA compliance;
    • Devices are properly installed; and
    • Timely and person-centered training and customer services for members on the use of devices.

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 CLLI645

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 CLLI646

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/SLS702

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/SLS648

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/SLS752

 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/SLS652

Required Certifications and/or Licenses:

  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.
  • 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/CHCBS656

Required Certifications and/or Licenses:

  • Home Care Agency Class A or Class B license from the Colorado Department of Public Health and Environment
  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.
  • 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

Independent Living Skills Training - BI654

Required Certifications and/or Licenses:

  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.
  • Home Care Agency (HCA) Class A or Class B 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: 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.
  • Home Care Agency (HCA) Class A or Class B license from the Colorado Department of Public Health and Environment.

Risk Level: Moderate
Tax ID Required: EIN
Fee Required: No
NPI Required: No
OOS Allowed: No
BT Allowed: No

Life Skills Training - CMHS/EBD/CIH/SLS753

Required Certifications and/or Licenses:

  • Colorado Department of Public Health and Environment Home Care Agency Class A or Class B license is required only for providers interested in providing members training on Personal Care.

    OR
     
  • A signed attestation on letterhead that states the provider is not providing members training on Personal Care.
  • 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:

  • Colorado Department of Public Health and Environment Home Care Agency Class A or Class B license is required only for providers interested in providing members training on Personal Care. (Attach a copy of the current license and complete the license information in revalidation.)

    OR
     
  • A signed attestation on letterhead that states the provider is not providing members training on Personal Care.

Risk Level: Moderate
Tax ID Required: EIN
Fee Required: No
NPI Required: No
OOS Allowed: No
BT Allowed: No

Massage Therapy - CIH881

Required Certifications and/or Licenses:

  • A DORA Massage Therapist license for each individual providing services.
  • A signed attestation, on letterhead, that each individual providing services demonstrates the following experience:
    • One (1) year of experience providing Massage Therapy 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 Massage Therapist license for each individual providing services.
  • A signed attestation, on letterhead, that each individual providing services demonstrates the following experience:
    • One (1) year of experience providing Massage Therapy 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

Mental Health Transitional Living Homes CMHS755

Assisted Living Residence License AND recommendation of approval from the Colorado
Department of Public Health and Environment. The Recommendation of approval 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

Assisted Living Residence License AND certification from the Colorado Department of Public
Health and Environment. 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

Mentorship - SLS659

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.
     
  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.

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

Non-Medical Transportation - BI/EBD/CIH/CMHS660

Required Certifications and/or Licenses:

  • Effective March 15, 2022, an IntelliRide Transportation Certificate of Compliance must be attached to new and maintenance applications. For more information regarding non-medical transportation (NMT) instructions, please visit the Non-Medical Transportation (NMT) Benefit web page.

Risk Level: Moderate
Tax ID Required: SSN or EIN
Fee Required: No
NPI Required: No
OOS Allowed: No
BT Allowed: Yes

Required Certifications and/or Licenses:

  • Effective July 1, 2022, an IntelliRide Transportation Certificate of Compliance must be attached to Revalidation applications. For more information regarding non-medical transportation (NMT) instructions, please visit the Non-Medical Transportation (NMT) Benefit web page.

Risk Level: Moderate
Tax ID Required: SSN or EIN
Fee Required: No
NPI Required: No
OOS Allowed: No
BT Allowed: Yes

Non-Medical Transportation - DD/SLS661

Required Certifications and/or Licenses:

  • Effective March 15, 2022, an IntelliRide Transportation Certificate of Compliance must be attached to new and maintenance applications. For more information regarding non-medical transportation (NMT) instructions, please visit the Non-Medical Transportation (NMT) Benefit web page.

Risk Level: Moderate
Tax ID Required: SSN or EIN
Fee Required: No
NPI Required: No
OOS Allowed: No
BT Allowed: Yes

Required Certifications and/or Licenses:

  • Effective July 1, 2022, an IntelliRide Transportation Certificate of Compliance must be attached to Revalidation applications. For more information regarding non-medical transportation (NMT) instructions, please visit the Non-Medical Transportation (NMT) Benefit web page.

Risk Level: Moderate
Tax ID Required: SSN or EIN
Fee Required: No
NPI Required: No
OOS Allowed: No
BT Allowed: Yes

Parent Education - CES662

Required Certifications and/or Licenses:

  • None

Risk Level: Limited
Tax ID Required: SSN or EIN
Fee Required: No
NPI Required: No
OOS Allowed: No
BT Allowed: No

Required Certifications and/or Licenses:

  • None

Risk Level: Moderate
Tax ID Required: EIN
Fee Required: No
NPI Required: Yes
OOS Allowed: No
BT Allowed: Yes

Peer Mentorship - BI/CMHS/EBD/CIH/DD/SLS754

Required Certifications and/or Licenses:

  • None

Risk Level: Moderate
Tax ID Required: EIN
Fee Required: No
NPI Required: Yes
OOS Allowed: No
BT Allowed: Yes

Required Certifications and/or Licenses:

  • None

Risk Level: Moderate
Tax ID Required: EIN
Fee Required: No
NPI Required: Yes
OOS Allowed: No
BT Allowed: Yes

Personal Care - SLS664

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.
     
  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.
     
  • Home Care Agency Class A or Class B license issued by the Colorado Department of Public Health and Environment

    OR
     
  • If CDPHE does not require a provider to obtain a Home Care Agency license for this specialty, a signed attestation on letterhead must be submitted that states one of the following:
    • Provider is an SSN provider that only has one employee
    • Provider is an EIN provider that only has one employee who provides hands-on assistance
    • Provider is an EIN provider that does not provide hands-on assistance
  • 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.
     
  • Home Care Agency Class A or Class B license issued by the Colorado Department of Public Health and Environment

    OR
     
  • If CDPHE does not require a provider to obtain a Home Care Agency license for this specialty, a signed attestation on letterhead must be submitted that states one of the following:
    • Provider is an SSN provider that only has one employee
    • Provider is an EIN provider that only has one employee who provides hands-on assistance
    • Provider is an EIN provider that does not provide hands-on assistance

Risk Level: Moderate
Tax ID Required: SSN or EIN
Fee Required: Yes
NPI Required: Yes
OOS Allowed: No
BT Allowed: No

Personal Care/Homemaker Services - BI/EBD/CIH/CMHS666

Required Certifications and/or Licenses:

  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.
  • Home Care Agency Class A or Class B 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: High
Tax ID Required: 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.
  • Home Care Agency Class A or Class B license issued by the Colorado Department of Public Health and Environment

Risk Level: Moderate
Tax ID Required: SSN or EIN
Fee Required: Yes
NPI Required: Yes
OOS Allowed: No
BT Allowed: No

Personal Emergency Response - SLS668

Required Certifications and/or Licenses:

  • In and out of state providers must attach policies and procedures ensuring:
    • Member rights, privacy and HIPAA compliance;
    • Devices are properly installed; and
    • Timely and person-centered training and customer services for members on the use of devices.

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 and out of state providers must attach policies and procedures ensuring:
    • Member rights, privacy and HIPAA compliance;
    • Devices are properly installed; and
    • Timely and person-centered training and customer services for members on the use of devices.

Risk Level: Moderate
Tax ID Required: SSN or EIN
Fee Required: No
NPI Required: No
OOS Allowed: Yes
BT Allowed: Yes

Prevocational Services - DD/SLS669

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.
     
  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.

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

Professional Services – Hippotherapy CES/SLS

670

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.
  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.
  • Licensure to include Physical Therapist (PT), Occupational Therapist (OT), or Speech Language Pathologist (SLP), AND AHCB Hippotherapy Certification or Hippotherapy Clinical Specialist Certification for each individual providing services.

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.
  • Licensure to include Physical Therapist (PT), Occupational Therapist (OT), or Speech Language Pathologist (SLP), AND AHCB Hippotherapy Certification or Hippotherapy Clinical Specialist Certification for each individual providing services.

Risk Level: Moderate
Tax ID Required: SSN or EIN
Fee Required: No
NPI Required: No
OOS Allowed: No
BT Allowed: No

Professional Services – Movement Therapy CES/SLS

672

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.
  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.

Board Certified Music Therapist certification or Dance Therapy certification.

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.
  • Board Certified Music Therapist certification or Dance Therapy certification (attach a copy of the certificate and complete the information in revalidation).

Risk Level: Moderate
Tax ID Required: SSN or EIN
Fee Required: No
NPI Required: No
OOS Allowed: No
BT Allowed: No

Professional Services-Massage - SLS/CES729

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.
     
  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.
  • Massage Therapy License for each individual providing services.

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:

  • Massage Therapy License for each individual providing services (attach a copy of current license(s) 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.


Risk Level: Moderate
Tax ID Required: SSN or EIN
Fee Required: No
NPI Required: No
OOS Allowed: No
BT Allowed: No

Remote Supports - BI/EBD/CIH/CMHS/SLS756

Required Certifications and/or Licenses:

  • Remote Supports Training Certificate obtained by completing the Remote Supports Provider Training
  • A signed attestation on letterhead that the platform used for Remote Supports is HIPAA compliant.
  • Policies and Procedures regarding:
    • Ensuring member privacy and HIPAA compliance
    • Rights of Participants
    • Contingency Plan for Provision of Remote Supports if Technology fails
    • Attestation that Professionals on staff may not practice outside of their respective scope
    • Maintaining an up-to-date person-centered plan for Remotes Supports service delivery
  • 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: Yes

Required Certifications and/or Licenses:

  • Remote Supports Training Certificate obtained by completing the Remote Supports Provider Training
  • A signed attestation on letterhead that the platform used for Remote Supports is HIPAA compliant.
  • Policies and Procedures regarding:
    • Ensuring member privacy and HIPAA compliance
    • Rights of Participants
    • Contingency Plan for Provision of Remote Supports if Technology fails
    • Attestation that Professionals on staff may not practice outside of their respective scope
    • Maintaining an up-to-date person-centered plan for Remotes Supports service delivery

Risk Level: Moderate
Tax ID Required: SSN or EIN
Fee Required: No
NPI Required: No
OOS Allowed: Yes
BT Allowed: Yes

Residential Habilitation Services - Group Home DD673

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.
     
  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.
  • Community Residential Home for Persons with Developmental Disabilities 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: No
BT Allowed: No

Required Certifications and/or Licenses:

  • Community Residential Home for Persons with Developmental Disabilities License from the Colorado Department of Public Health and Environment.
  • 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

Residential Habilitation Services-IRSS/Host Hme - DD674

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.
     
  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.
  • As of January 1, 2020, IRSS providers must pass the Colorado Division of Housing (DOH) IRSS Inspection Protocol every two years. All Host Homes and IRSS settings that are owned or leased by a PASA must pass the inspection. Please note that Family Caregiver Settings are excluded from this requirement. To request an inspection, please email the Division of Housing at IRSS.residential.inspections@state.co.us for inspection information. This does not need to be done prior to enrollment but should be done as soon as possible to ensure your agency meets timeline requirements.

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

Respite - BI/EBD/CIH/CMHS675

Providers must meet one of the following sets of requirements:

  • Home Care Agency (HCA) Class A or Class B license issued by the Colorado Department of Public Health and Environment (CDPHE) AND Certification for Personal Care/Homemaker Services BI/EBD/CHI/CMHS from CDPHE. Existing Specialty 666 Personal Care/Homemaker Services BI/EBD/CHI/CMHS and Specialty 664 Personal Care CES/SLS providers are not required to attach their CDPHE certificate to the application.
  • Assisted Living Residence license issued by CDPHE AND Alternative Care Facility certification issued by CDPHE. Providers currently enrolled in Specialty 602 Alternative Care Facility are not required to attach their CDPHE ACF certificate to the application.
  • Long-Term Care license for a Nursing Facility 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: EIN
Fee Required: No
NPI Required: Yes
OOS Allowed: No
BT Allowed: No

Required Certifications and/or Licenses:

  • Home Class 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) AND certification for Personal Care/Homemaker Services from the Colorado Department of Public Health and Environment. The certification is not required to be attached to the application.
  • Assisted Living Residence license from the Colorado Department of Public Health and Environment (attach a copy of current license and complete the license information in revalidation) AND certification for Alternative Care Facility from the Colorado Department of Public Health and Environment. The certification is not required to be attached to the application.
  • Long-Term Care license for a Nursing Facility 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: EIN
Fee Required: No
NPI Required: Yes
OOS Allowed: No
BT Allowed: No

Respite - CES/SLS676

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.
  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.
  • Home Care Agency Class A or Class B license issued by the Colorado Department of Public Health and Environment

    OR
     
  • If CDPHE does not require a provider to obtain a Home Care Agency license for this specialty, a signed attestation on letterhead must be submitted that states one of the following:
    • Provider is an SSN provider that only has one employee
    • Provider is an EIN provider that only has one employee who provides hands-on assistance
    • Provider is an EIN provider that does not provide hands-on assistance
  • 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: Yes
OOS Allowed: No
BT Allowed: Yes

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.
  • Home Care Agency Class A or Class B license issued by the Colorado Department of Public Health and Environment

    OR
     
  • If CDPHE does not require a provider to obtain a Home Care Agency license for this specialty, a signed attestation on letterhead must be submitted that states one of the following:
    • Provider is an SSN provider that only has one employee
    • Provider is an EIN provider that only has one employee who provides hands-on assistance
    • Provider is an EIN provider that does not provide hands-on assistance

Risk Level: Moderate
Tax ID Required: SSN or EIN
Fee Required: No
NPI Required: Yes
OOS Allowed: No
BT Allowed: Yes

Specialized Med Equipment/Supplies - CES/DD/SLS677

Required Certifications and/or Licenses:

  • In and out of state providers must attach policies and procedures ensuring:
    • Member rights, privacy and HIPAA compliance;
    • Devices are properly installed; and
    • Timely and person-centered training and customer services for members on the use of devices.

Risk Level: High
Tax ID Required: SSN or EIN
Fee Required: Yes
NPI Required: No
OOS Allowed: Yes
BT Allowed: Yes

Required Certifications and/or Licenses:

  • In and out of state providers must attach policies and procedures ensuring:
    • Member rights, privacy and HIPAA compliance;
    • Devices are properly installed; and
    • Timely and person-centered training and customer services for members on the use of devices.

Risk Level: Moderate
Tax ID Required: SSN or EIN
Fee Required: Yes
NPI Required: No
OOS Allowed: Yes
BT Allowed: Yes

Substance Abuse Counseling - BI678

Required Certifications and/or Licenses:

  • Certified Addiction Counselor II or Psychologist License from the Colorado Department of Regulatory Agencies (DORA).
  • 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 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: No
BT Allowed: No

Required Certifications and/or Licenses:

  • Certified Addiction Counselor II or Psychologist License from the Colorado Department of Regulatory Agencies (DORA).
  • 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 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: No
BT Allowed: No

Supported Employment - DD/SLS679

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.
     
  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.

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

Supported Living Program - BI680

Required Certifications and/or Licenses:

  • Assisted Living Residence License or Home Care Agency Class A 
  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.

Risk Level: Moderate
Tax ID Required: EIN
Fee Required: No
NPI Required: No
OOS Allowed: No
BT Allowed: No

Required Certifications and/or Licenses:

  • Assisted Living Residence License or Home Care Agency Class A 
  • 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

Transition Setup - BI/CMHS/EBD/CIH/DD/SLS636

Required Certifications and/or Licenses:

  • None

Risk Level: Moderate
Tax ID Required: EIN
Fee Required: No
NPI Required: No
OOS Allowed: No
BT Allowed: No

Required Certifications and/or Licenses:

  • None

Risk Level: Moderate
Tax ID Required: EIN
Fee Required: No
NPI Required: No
OOS Allowed: No
BT Allowed: No

Transitional Living Program - BI682

Required Certifications and/or Licenses:

  • Assisted Living Residence License or Home Care Agency Class A License from the Colorado Department of Public Health and Environment
  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.
  • Commission of the Accreditation of Rehabilitation Facilities (CARF) accreditation may waive the on-site review for initial certification. However, on-site reviews of all programs shall occur on at least a yearly basis.

Risk Level: Moderate
Tax ID Required: EIN
Fee Required: No
NPI Required: No
OOS Allowed: No
BT Allowed: No

Required Certifications and/or Licenses:

  • Assisted Living Residence License or Home Care Agency Class A License from the Colorado Department of Public Health and Environment
  • 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

Vehicle Modifications - CES/SLS685

Required Certifications and/or Licenses:

  • None

Risk Level: Limited
Tax ID Required: SSN or EIN
Fee Required: No
NPI Required: Yes
OOS Allowed: No
BT Allowed: No

Required Certifications and/or Licenses:

  • None

Risk Level: Limited
Tax ID Required: SSN or EIN
Fee Required: No
NPI Required: Yes
OOS Allowed: No
BT Allowed: No

Vision - DD/SLS687

Required Certifications and/or Licenses:

  • Optometry license from the Colorado Department of Regulatory Agencies (DORA).
  • License from the Colorado Dept. of Regulatory Agencies or of out-of-state license from own state.

Risk Level: Limited
Tax ID Required: SSN or EIN
Fee Required: No
NPI Required: Yes
OOS Allowed: No
BT Allowed: No

Required Certifications and/or Licenses:

  • Optometry license from the Colorado Department of Regulatory Agencies (DORA).
  • License from the Colorado Dept. of Regulatory Agencies or of out-of-state license from own state.

Risk Level: Limited
Tax ID Required: SSN or EIN
Fee Required: No
NPI Required: Yes
OOS Allowed: No
BT Allowed: No

Youth Day Services - CES751

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.
     
  • Initial Certification or Add Service Certification from the Colorado Department of Public Health and Environment must be attached to the application. Certificates can be downloaded from the CDPHE COHFI Provider Portal.
  • 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: Yes
OOS Allowed: No
BT Allowed: No

Required Certifications and/or Licenses:

  • Certification from the Colorado Department of Public Health and Environment (CDPHE). 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