Senate Bill 23-174: Coverage Policy

Select Behavioral Health Services for Members Under 21

In 2023, the Colorado Legislature passed Senate Bill 23-174 that required the Department of Health Care Policy and Financing (HCPF) to provide access to a limited set of behavioral health services to members under the age of 21 without a covered diagnosis. The legislation detailed service categories that must be included under this coverage, and HCPF engaged stakeholders to identify the specific service codes that are included. This coverage policy goes into effect July 1, 2024.  

There are eighteen (18) services covered under the “174 Coverage Policy”.  These are listed below and are indicated in the State Behavioral Health Services (SBHS) Billing Manual, Appendix I, highlighted in blue, as well as the School Health Services (SHS) Program Manual Section 2 and the SHS Billing Manual.

When a practitioner provides any of the included services to a member under the age of 21 they are allowed to use one of the listed symptomology or Social Determinant of Health (SDOH) codes in the diagnosis box of a claim.  If a member meets the criteria for a Behavioral Health condition it is best practice to use the clinical diagnosis on a claim for services provided.

References and Resources

March 2024 Stakeholder Forum


For School Health Services:

  • Stakeholder Forum - November 17, 2023
  • SHS Program Newsletter - December 2023
  • Emails to School Districts/BOCES and their billing agents - March 2024
  • SHS Program Manual Section 2 updated by July 1, 2024
  • SHS Billing Manual updated by July 1, 2024
  • Annual Training - August 2024
  • SHS Program Newsletter - June 2024

For the Capitated Behavioral Health Benefit: