Nursing Facility Application Requirements and Enrollment
Becoming a New Nursing Facility Medicaid Provider
There are several steps to becoming a Medicaid-certified new nursing facility or adding additional Medicaid beds to your facility.
- Prior approval is required before opening a new facility.
- Prior approval is required before enrolling as an out-of-state facility.
- Each January and July, a new or non-Medicaid nursing facility can apply to become a Medicaid facility if the county (service area) can be reasonably served by that nursing facility. Review 10 CCR 2505-10, Section 8.430 - Medicaid Certification of New Nursing Facilities or Additional Beds regulations.
Steps:
- Application opportunities occur twice a year in January and July for a new or non-Medicaid nursing facility to apply to become a Medicaid facility if the county (service area) can be reasonably served by that nursing facility. Review the Department of Health Care Policy and Financing (HCPF) regulations 10 CCR 2505-10, Section 8.430 - Medicaid Certification of New Nursing Facilities or Additional Beds
- Email Christine.Bates1@state.co.us or HCPF_LTC_Facilities@state.co.us to get application instructions and materials
- All Nursing Facility Applications for Medicaid Certification require a 30-day public comment period.
- If your application is approved by HCPF, you will then need to obtain appropriate licensure from the Colorado Department of Public Health and Environment (CDPHE)
- Enroll as a Medicaid provider with HCPF. Enrollment requires a billing account(s). If you have questions about the enrollment process, contact Provider Services.
Helpful Resources:
- Quick Reference Guides
- Provider Enrollment Guide
- Provider Enrollment Types
- Provider Participation Agreement - this is signed through the online provider enrollment tool.
Nursing Facility Provider Codes
Enrollment Type: Facility
Provider Type, Specialty Code – Description
- PT 20, SC 382 – NF Hospital Backup Unit (HBU)
- PT 20, SC 392 – NF Regular
- PT 20, SC 392 – NF Regular (Limited Beds)
- PT 20, SC 392 – NF Regular (QMB Only)
- PT 20, SC 396 – NF Swing Bed (in CAH)
- PT 21, SC 383 – ICF (Privately Owned)
- PT 21, SC 394 – ICF (State Owned)
Note: Hospice is provider type 50 and Respite is provider type 36.
If you are unsure which type of account to open, email Cathy.Fielder@state.co.us
Providing the public an opportunity to review and comment on the application materials from agencies applying to be new Medicaid Nursing Facilities in Colorado.
Public Comment Opportunity
Nothing to review at this time.
If you have questions, email Richard.Clark@state.co.us and Christine.Bates1@state.co.us