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The Department of Health Care Policy and Financing is following the lead of the Governor’s Task Force in reducing the misuse of prescription opioids. In order to support this campaign there will be limitations on morphine equivalents and pill quantities, and we are instituting quantity limits on short-acting opioids of a maximum of 4 tablets per day (equating to 120 tablets per 30 days). Through this policy we are attempting to reduce client utilization of short-acting opioids and maintain or improve client levels of stability and functionality.
In a continued effort to address the growing opioid epidemic in Colorado, the Department of Health Care Policy and Financing (Department) is tightening its policy on prescribing and dispensing opioid pain medications to Health First Colorado (Colorado’s Medicaid program) members. The new policy will include limiting the supply of opioids to members who haven’t had an opioid prescription in the past 12 months and a reduction in limitation for morphine equivalents. Please see the short-acting opioid tab for more information.
Courtesy of National Safety Council on Acute Pain:
Morphine Equivalents Policy and PA Criteria
Morphine Equivalent Conversion Table
Methadone Conversion Factors
Please exercise great caution when converting patients from one opioid to another as issues of cross-tolerance and agent pharmacokinetics can create a potentially life-threatening situation. If a telephone consult is needed with a pain management physician (free of charge for Medicaid members), please email SSPPS.firstname.lastname@example.org
Stakeholder communication regarding new short-acting opioid policy (2017)
Stakeholder communication regarding new short-acting opioid policy (2014)
The State of Colorado believes it is important to provide information about opioids and intends this page to be a resource. It is intended to provide additional information about opioids, their use, potential misuse, as well as information about substance abuse/misuse programs, however it is not meant to be all inclusive. This page provides links to a handful of external websites that are not the property of, or the responsibility of the State of Colorado. Upon the selection of such a link you will leave the Colorado Department of Health Care Policy and Financing’s website. The State of Colorado is not responsible for the content of the linked web pages or the dependability, accuracy or information security of these sites. The State of Colorado does not endorse or sponsor the companies, products or services that may be offered at these websites nor should such an endorsement be implied. The links are not listed in any particular order of importance.
Note: Providers billing for substance use Screening, Brief Intervention, and Referral to Treatment (SBIRT) services
Based on health and cost benefits of SBIRT, the AMA instituted healthcare codes for substance use screening and brief intervention
H0049 and H0050 for Medicaid: See Medicaid Billing Manual for SBIRT
99408 and 99409 for privately insured patients
G0396 and G0397 for Medicare patients
Senate Bill 13-014 CONCERNING THE USE OF OPIATE ANTAGONISTS TO TREAT PERSONS WHO SUFFER OPIATE-RELATED DRUG OVERDOSE EVENTS – including prescribing naloxone to a layperson (see Section 4)