Welcome to the Health First Colorado Behavioral Health Updates

Health First Colorado Behavioral Health Updates provides content relevant to the full spectrum of behavioral health services in Colorado. Feel free to forward this newsletter to other interested stakeholders!   

Feedback, ideas, and questions are welcome and can be shared at hcpf_bhbenefits@state.co.us

Behavioral Health Legislative Request for Information 

HCPF produced a report November 1, 2024, describing the capitated behavioral health benefit and how many members utilized behavioral health services during Fiscal Year 2022-23. This report also includes data on the time it took to process and pay provider claims in 2023, how managed care entities contract with providers to expand their networks, and reports on the timeliness of contracting and credentialing during 2023. Read the full Legislative Request for Information. 

Benefit Spotlight

Medicaid Transportation Benefits 

Medicaid offers an array of transportation options to help members get where they need to go. Here is a graphic outlining the differences between types of transportation offered. 

Click the links to learn more about Non-Medical Transport (NMT), Non-Emergent Medical Transportation (NEMT), Behavioral Health Secure Transportation (BHST) or Emergency Medical Transportation. Recent updates to NEMT can be found in the NEMT Bulletin. 

FAQs/Clarifications of Coverage and Billing Questions

Behavioral Therapy Clinics 

Behavioral Therapy Clinic Provider Type 83 provides services for children/youth under age 21 who have an autism spectrum disorder or similar condition generally through Applied Behavioral Analysis (ABA). With the expansion of the Behavioral Health Safety Net, please note that Provider Type 83 is not an eligible safety net provider type. If an agency provides ABA and would like to also provide safety net services, they must enroll and submit claims for safety net services through an appropriately eligible provider type listed in Appendix L of the SBHS Billing Manual.

Community Mental Health Centers 

All providers who are currently enrolled with HCPF as a Community Mental Health Center (CMHC) Provider Type 35 must enroll with HCPF as a Comprehensive Provider (provider type 78), Essential Provider (various provider types), or Behavioral Health Group (provider type 77) no later than December 31, 2024. CMHCs will not be able to submit claims to HCPF or a Regional Accountable Entity (RAE) for dates of service after December 31, 2024.  Provider Type 35 (CMHC) will be removed from the January 1, 2025, SBHS Billing Manual. See HCPF Operational Memo 23-077 for more information. 

Other Things Happening in Behavioral Health

Eating Disorder Task Group 

Senate Bill (SB) 24-117 mandates that agencies providing eating disorder treatment and recovery (EDTR) become designated by BHA to provide those services.  The law further states all EDTR agencies providing residential, inpatient, intensive outpatient (IOP) or partial hospitalization (PHP) levels of care must be designated by January 1, 2026. 

To develop rules and standards for these services, BHA is forming a Task Group, meeting regularly for 4-6 months starting in early January 2025. Those interested in joining should apply by December 13, 2024. The group, limited to 15 participants, seeks diverse backgrounds, including lived experience, age, demographics, and geographic representation across Colorado. 

Connect with Us

Behavioral Health Provider Engagement Opportunities 

Behavioral health providers are encouraged to participate in provider forums, meetings and office hours. Below are a series of ongoing opportunities available. Many of these sessions require registration to allow for planning based on attendance and to prepare responses and presentations designed to address questions often submitted in advance.  

Forums: Designed to be a space for presentation of information and discussion:  

• Independent Provider Network Forum - Quarterly First Friday 1:00 – 2:00 PM. Register in advance.    
• SUD Forum – Quarterly First Wednesday 2:00 – 3:00 PM. Register in advance.   
• Peer Support Workforce Collaborative Meetings led by BHA – Quarterly First Thursday 12-1:30 PM. Register in advance through the BHA’s Stakeholder Calendar.   
• Behavioral Health Hospital Engagement Forum – Quarterly Second Friday 10:00 -11:00 AM. Register in advance.  

Office Hours and Technical Assistance: Designed to be a “drop in” space for quick answers to issues best addressed by a brief discussion:   

• Crisis Provider TA – Monthly Second Tuesday 11:00 a.m. - noon. Register in advance.    
• SUD Provider TA - Monthly on the 1st Wednesday 2:00 – 3:00 p.m. Register in advance.    
• Housing Provider TA - Monthly on the last Thursday 2:00 – 3:00 p.m. Register in advance.   
• Peer Providers TA - Monthly on the 4th Thursday 12:00 – 1:00 p.m. Register in advance. 
• Safety Net Provider Office Hours – Monthly Last Friday 10:00 – 11:00 AM. Register in advance. 
• Mental Health Transitional Living Home – Level 2 Office Hours – Thursdays 2:00 – 3:00PM 

Share your feedback, ideas and questions: hcpf_bhbenefits@state.co.us