Medicaid Provider Rate Review Annual Reports
Use the drop-down menus below to view services reviewed each year and the Department's accompanying Analysis and Recommendation Reports.
- Second Five-Year Review Cycle (2021-2025)
-
2022
Year Two Services:
- Physician Services
- Dialysis & Nephrology
- Eyeglasses & Vision
- Laboratory & Pathology
- Injections & Miscellaneous J-Codes
2022 Medicaid Provider Rate Review Analysis Report
- Appendix A - Glossary & Colorado State County Classification Map
- Appendix B - Physician Services Data & Methodologies
- Appendix C - Dialysis, Vision, Laboratory, & Injections Data & Methodologies
- Appendix D - Service Groupings Data Book
- Appendix E - COVID-19 Impact on Services
- Appendix F - Respiratory Services Additional Data
- Appendix G - Out-of-Cycle Review Data Analysis Methodology
2022 Medicaid Provider Rate Review Recommendation Report
2021
Year One Services:
- Emergency Medical Transportation (EMT)
- Non-Emergent Medical Transportation (NEMT)
- Home and Community-Based Services (HCBS) Waivers
- Targeted Case Management (TCM)
Report Documents
2021 Medicaid Provider Rate Review Analysis Report (Main Report)*
- Appendix A - Glossary
- Appendix B - Transportation Data and Methodologies
- Appendix C - HCBS and TCM Data and Methodologies
- Appendix D - CDASS Rate Analysis
- Appendix E - Service Groupings Data Book
- Appendix F - HCBS Service Groupings by Waiver
- Appendix G - Rate Comparison with PACE and HCBS Services
- Appendix H - OCL Stance on Direct Care Workforce
- Appendix I - COVID-19 Impact on Services
- Appendix J - Transportation Services Visual Data
*Please note that the Medicaid Provider Rate Review Advisory Committee (MPRRAC) does not agree with the findings of this report, specifically regarding Transportation Services.
2021 Medicaid Provider Rate Review Recommendation Report
- First Five-Year Review Cycle (2016-2020)
-
2020
Year Five Services:
- Pediatric Personal Care
- Pediatric Behavioral Therapy
- Prosthetics, Orthotics, and Supplies
- Vision Services
- Home Health Services
- Private Duty Nursing
- Speech Therapy
- Physical and Occupational Therapy
2020 Medicaid Provider Rate Review Analysis Report
2020 Medicaid Provider Rate Review Recommendation Report
2019
Year Four Services:- Ambulatory Surgical Centers
- Fee-for-Service Behavioral Health Services
- Residential Child Care Facilities
- Psychiatric Residential Treatment Facilities
- Special Connections Program Services
- Dialysis
- Durable Medical Equipment
2019 Medicaid Provider Rate Review Analysis Report
- Appendix A - Glossary
- Appendix B - Rate Comparison and Access to Care Analysis Methodologies
- Appendix C - Service Grouping Data Book
2019 Medicaid Provider Rate Review Recommendation Report
2018
Year Three Services:- Evaluation and Management
- Primary Care Services
- Radiology
- Physical and Occupational Therapy
- Maternity Services
- Surgeries
- Physician Services
- Dental Services
2018 Medicaid Provider Rate Review Analysis Report
- Appendix A - Glossary
- Appendix B - Rate Comparison Analysis Methodology
- Appendix C - Access to Care Analysis Methodology
- Appendix D - Service Grouping Data Books
- Appendix E - Dental Services Rate Comparison Analysis Methodology
- Appendix F - Rate Ratio Scatterplots
2018 Medicaid Provider Rate Review Recommendation Report
2017
2017 Medicaid Provider Rate Review Analysis Report - Physician Services, Surgery, and Anesthesia
- Appendix A - Payment Comparison Methodology
- Appendix B - Rate Data Book
- Appendix C - Access Analysis Methodology
- Appendix D - Access Data Book
- Appendix A - Payment Comparison Methodology
- Appendix B - Aggregate Utilization Data for Common Adult LTSS Waivers by Waiver
- Appendix C - Rate Review Process and Consumer Directed Attendant Support Services
2017 Medicaid Provider Rate Review Recommendation Report
2016
Year One Services:- Laboratory and Pathology
- Private Duty Nursing
- Home Health
- Non-Emergent Medical Transportation
- Emergency Medical Transportation
- Physician-Administered Drugs
2016 Medicaid Provider Rate Review Analysis Report
2016 Medicaid Provider Rate Review Recommendation Report