Department Program Rules - Code of Colorado Regulations
To access the text of the Secretary of State's (SOS)
official online version of the Department's rules, click on the links below.
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Children's Basic Health Plan
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10 CCR 2505-3
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300 - Enrollment Fees/Co-payments
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50 - Definitions
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400 - Enrollment
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100 - Eligibility
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500 - Financial Management
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200 - Benefits Package
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600 - Appeals
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Medical Assistance
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10 CCR 2505-10
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8.011 General Exclusions From Coverage
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8.061 Assistance Benefits
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8.012 Prohibition of Charges to Recipients
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8.062 Social Security Medicare Benefits
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8.013 Out of State Medical Care
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8.063 Medical Assistance Estate Recovery
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8.014 Non-Emergent Medical Transportation
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8.065 Recovery of Medical Assistance Overpayments
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8.040 Recoveries From Providers
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8.066 Health Insurance Buy-In
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8.041 Claims Reimbursement and Status
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8.070 Mis-Utilization, Fraud, or Abuse
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8.042 Utilization Cash Accounting
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8.075 Client Over Utilization Program
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8.043 Timely Filing Requirements
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8.076 Program Integrity
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8.049 Reconsideration/Appeal of Adverse Administrative Action
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8.079 Quality Improvement
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8.050 Provider Appeals
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8.080 Medicaid Eligibility Quality Control
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8.057 Recipient Appeals
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8.090 Quality Control
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8.058 Request for Prior Authorization
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8.100 Medical Assistance Eligibility
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8.100.6 Aged, Blind and Disabled Medical Assistance Eligibility
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8.100.1 Definitions
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8.100.7 Long Term Care Medical Assistance Eligibility
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8.100.2 Legal Basis
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8.130 Provider Participation
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8.100.3 Medical Assistance General Eligibility Requirements
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8.170 State Identification Number |
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8.100.4 Family and Children's Medical Assistance Eligibility
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8.180 Medical Identification Cards and Duration of Eligibility
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8.100.5 Aged, Blind and Disabled Medical Assistance General Eligibility
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8.190 Acute Medical Benefits Determination |
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8.200 Physician Services
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8.281 EPSDT Eligibility
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8.201 Treatment of Oral Medical Conditions for Adult Clients
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8.282 Services/Benefits
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8.205 Medicaid Managed Care Program
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8.283 Provider Requirements/Responsibilities
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8.212 Community Mental Health Services
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8.284 Prior Authorizations
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8.220 Competitive Procurement and Selective Contracting, Including Global Fee Payment Programs
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8.285 Reimbursement
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8.221 General Provisions 8.280 Early Periodic Screening Diagnosis and Treatment (EPSDT)
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8.290 School Health Benefits
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8.300 Hospital Services
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8.332 Payment
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8.301 Hospital Definition
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8.333 Outpatient Psychiatric Services
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8.302 Medicaid Participating Hospital Requirements
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8.340 Graduate Medical Education (GME) and Disproportional Share Hospital (DSH) Payments to Hospitals for Medicaid Managed Care
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8.303 Emergency Care
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8.341 GME for Medicaid Managed Care - Inpatient Services
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8.304 Surgery Benefits
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8.342 GME for Medicaid Managed Care - Outpatient Services
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8.305 Non-Participating Hospitals
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8.350 Payment of Hospital Costs for Non-PPS Providers and Units
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8.310 Inpatient Hospital Services
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8.351 Methods for Determining Rates for Exempt Providers
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8.313 Review of Admission and Continued Stay
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8.352 Review Procedures Carried Out By the Department
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8.314 Retrospective Review
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8.353 Rate Review Board
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8.315 Preadmission Review
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8.354 Administrative Review
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8.316 Second Opinion Review
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8.355 Forms to be Used Concerning the Payment Rate for Hospitals
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8.317 Prior Authorization Review
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8.356 Payments for Inpatient Hospital Services
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8.318 Administrative Denial and Appeal Procedures
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8.358 Patient Payment Calculation for Nursing Facility Clients Who Are Hospitalized
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8.319 Hospitalization and Extensions Concerning Newborn Infants |
8.373 Inpatient Psychiatric Care for Individuals Under the Age of 21
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8.320 Dialysis
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8.374 Payment for Inpatient Services at Free Standing Psychiatric Hospitals
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8.321 Inpatient Hospital (Acute Dialysis)
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8.375 Swing-Bed Hospitals
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8.322 Outpatient Dialysis
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8.390 Long Term Care Single Entry Point System
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8.323 Home (Chronic Dialysis)
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8.391 Single Entry Point District Designation
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8.324 Payment for Dialysis Treatments
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8.392 Financing of the Single Entry Point System
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8.325 Reimbursement for all Routine and Non-Routine Ancillary Dialysis Services
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8.393 Functions of a Single Entry Point Agency
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8.330 Outpatient Hospital Services
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8.394 Accountability Mechanisms
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8.331 Definitions
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8.400 Long Term Care
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8.443 Nursing Facility Reimbursement
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8.401 Level of Care Screening Guidelines
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8.444 - 8.446 REPEALED
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8.402 Admission Procedures for Long Term Care
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8.448 REPEALED
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8.403 Long Term Care - Services to the Developmentally Disabled
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8.461 REPEALED
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8.404 Admission Criteria: Programs for the Developmentally Disabled |
8.470 Hospital Back Up Level of Care
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8.405 Admission Procedures: Programs for the Developmentally Disabled
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8.481 Medical Review/Independent Professional Review
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8.406 Nursing Facility Care - Levels of Care
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8.482 Resident Income and Possessions
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8.407 Special Provision Concerning Clients Eligible for Social Security Age -72 Benefits (PROUTY)
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8.483 Adult Foster Care - REPEALED
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8.408 Levels of Care Defined - Skilled Nursing Care
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8.484 Home Care Allowance - REPEALED
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8.409 Levels of Care Defined - Intermediate Nursing Care
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8.485 Home and Community Based Services for the Elderly, Blind and Disabled (HCBS-EBD) General Provisions
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8.415 Role of Counties and Nursing Facilities
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8.486 HCBS-EBD Case Management Functions
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8.420 Requirements and Provisions for Participation by Colorado Nursing Facilities
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8.487 HCBS-EBD Provider Agencies
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8.421 Responsibility of County Department Concerning Participation
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8.488 Electronic Monitoring
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8.422 Visits to Recipients by Social Services Personnel, privacy for Conferences with Recipients
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8.489 Personal Care
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8.423 Visits to Recipients by the Colorado Long Term Care Ombudsman and Designated Representatives
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8.490 Homemaker Services
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8.424 Periodic Visits - Nursing Home Records to be Made Available
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8.491 Adult Day Services
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8.430 Medicaid Certification of New Nursing Facilities or Additional Beds
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8.492 Respite Care
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8.435 Enforcement Remedies
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8.493 Home Modification
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8.440 Nursing Facility Benefits
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8.494 Non-Medical Transportation
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8.441 Nursing Facility Cost Reporting
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8.495 Alternative Care Facilities
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8.442 Submission of Cost Reporting Information
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8.496 Home and Community Based Services for Persons Living with AIDS (HCBS-PLWA) General Provisions
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8.500 Home and Community Based Services for the Developmentally Disabled (HCBS DD) Waiver
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8.527 Prior Authorization
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8.500.90 Supported living Services (SLS) Waiver
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8.528 Reimbursement
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8.503 Children's Extensive Support Waiver Program
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8.529 Post-Payment Review
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8.504 Home and Community Based Services -Pediatric Hospice Waiver
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8.530 Denial, Termination, or Reduction in Services
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8.506 Children's Home and Community Based Services Waiver Program
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8.540 Private Duty Nursing Services
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8.508 Children's Habilitation Residential Program
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8.550 Hospice Benefit
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8.509 Home and Community Based Services for Persons With Mental Illness (HCBS MI)
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8.551 Consumer Directed Attendant Support
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8.510 Consumer Directed Attendant Support Services
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8.552 In Home Support Services
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8.515 Home and Community Based Services for People with Brain Injury (HCBS BI)
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8.553 Community Transition Services
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8.516 Environmental Modification
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8.560 Clinic Services - Certified Health Agencies
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8.518 Consumer Directed Care for the Elderly
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8.570 Ambulatory Surgery Centers
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8.519 Home and Community Based Services for Children with Autism
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8.580 Oxygen and Oxygen Equipment
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8.520 Home Health Services
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8.585 Oxygen, Oxygen Equipment, and Supplies
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8.525 Services Requirements
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8.590 Durable Medical Equipment and Disposable Medical Supplies
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8.526 Provider Agency Requirements
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8.660 Laboratory and X-Ray
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8.700 Federally Qualified Health Centers
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8.748 Prenatal Plus Program
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8.715 Breast and Cervical Cancer Program
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8.749 Nurse Home Visitor Program
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8.726 Teen Pregnancy Prevention Pilot Program
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8.750 Community mental Health Centers/Clinics
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8.730 Family Planning Services
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8.760 Targeted Case Management Services
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8.740 Rural Health Clinics
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8.765 Services for Clients in Psychiatric Residential Treatment Facilities or Residing in Therapeutic Residential Child Care Centers
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8.745 Special Connections
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8.766 Residential Treatment Center Reimbursement
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8.746 Outpatient Substance Abuse Treatment
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8.800 Pharmaceuticals
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8.900 Colorado Indigent Care Program (CICP)
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8.940 Old Age Pension Health Care Program and Old Age Pension Health Care Supplemental Program
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8.930 Comprehensive Primary and preventive Care Grant Program
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8.950 Primary Care Fund
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8.1000 Medicare Modernization Act - Low-Income Subsidy Eligibility
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