What’s New 

This will be the last edition of the HCPF SUD Newsletter. Starting in July, you will be automatically added to the new Medicaid Behavioral Health Newsletter. In partnership with other State agencies, HCPF is working to develop a comprehensive behavioral health safety net. The Medicaid Behavioral Health Newsletter will provide content relevant to the full spectrum of behavioral health services in Colorado.   

Sign up for next Quarterly SUD Provider Forum – July 3, 2024 

The Quarterly SUD Provider Forum is open to providers and other stakeholders to learn about policies, changes and expectations of service delivery and billing in the SUD continuum of care. This is a presentation-style meeting held quarterly on the first Wednesday of the month from 2:00 - 3:00 pm. The next SUD Provider Forum is Wednesday, July 3, 2024. Review the Provider Forum Agenda and register via Zoom. 

Take Note

New Specialty Types under PT 64  

New specialty types under PT 64 Substance Use Disorder (SUD) Continuum will be effective July 1st to align with the Behavioral Health Administration (BHA) endorsements. Providers will not need to re-enroll but rather will complete a maintenance request to update your specialty type (ST) from 477 to the new specialty type based on your BHA endorsements. This includes opioid treatment program (OTP) providers who have been enrolled under PT 64/ST 477. There are two new ST for OTP providers depending on how long you have had your SAMHSA certificate. 

FFS SUD Services 

The following SUD services are covered under our Fee-For-Service (FFS) Behavioral Health Benefit in instances where a member is not yet assigned to a Regional Accountable Entity (RAE): 

CCBHC Stakeholder Forum 

HCPF, in collaboration with the BHA, is launching a Certified Community Behavioral Health Clinic (CCBHC) Stakeholder forum. Forums will be held regularly beginning July 24, 2024. 

The purpose of these forums is to strengthen HCFP’s collaboration and partnership with behavioral health providers, care centers, and advocates from across Colorado as we prepare to apply for an upcoming CCBHC Planning Grant. The forum will be a space for all stakeholders to provide updates, lessons learned, challenges, and ideas to inform Colorado’s CCBHC Planning Grant application and potentially the future CCBHC structure that is right for Colorado. A notice of funding opportunity to award 15 additional states with planning grants is expected to be posted this summer for award early in Fiscal Year 2025. Please sign-up to attend the upcoming Kick-Off Forum. 

For more information, please visit the HCPF CCBHC webpage. You may also reach out via email to Carly Donohue-Torres at or hcpf_safetynetforum@state.co.us. Please include “CCBHC” in your subject line. 

Update to Buprenorphine Coverage 

Effective July 1, 2024, HCPF will allow buprenorphine doses greater than 24mg based on provider attestation through the prescriber tool. The prescriber tool will allow authorization at the time of prescribing through the EHR with no call or fax needed. HCPF is also extending the approval time period from 6 months to 12 months. 

Debunking Myths & Misinformation About Health First Colorado

Did you know...

Some, but not all, components of urinalysis (UA) are reimbursable by Medicaid 

There are three components to a UA: collection, analysis, and counseling.   

1. Collection of a urine specimen alone is not reimbursable. 
2. The analysis of the specimen is billed fee-for-service by the laboratory. According to rule and Laboratory billing guidelines, a physician’s order is required for a lab to bill for analysis.  
3. The review of results and counseling provided to a member can be billed to a Managed Care Entity (MCE) by using HCPCS code S9445. 

Other Things Happening in the SUD Space 

Now Open: Substance Use Disorder Treatment and Recovery Loan Repayment Program 

Are you passionate about helping those with substance use disorders? If you are a behavioral health clinician or support worker, clinical support staff, or trained in substance use disorders, you can apply to the Substance Use Disorder Treatment and Recovery Loan Repayment Program (STAR LRP) and receive up to $250,000 in loan repayment. In exchange, you must work full-time for six years in a STAR LRP-approved facility. 

Telehealth and Medications for Opioid Use Disorder 

Earlier this year, the U.S. Department of Health & Human Services published a Final Rule permanently allowing OTPs to use phone-only or video-based telehealth in initiating buprenorphine treatment, a flexibility introduced during the COVID-19 pandemic. Studies show that treatment with buprenorphine, a form of medication for opioid use disorder (MOUD), via telehealth has the same or better retention outcomes compared to in-person treatment. The rule also permanently allows certain flexibilities for “take-home” doses of methadone, a form of MOUD that can only be dispensed by OTPs. 

Other types of health care providers, such as hospitals and primary care providers, who care for people with opioid use disorder can consider partnering more closely with OTPs given these now permanent telehealth flexibilities for buprenorphine treatment. 

Center for Health Care Strategies recently published this Better Care Playbook Evidence Roundup which can assist health care organizations and policymakers in better understanding evidence on the use of telehealth in MOUD treatment.