Provider Enrollment Types

Instructions for Step 2

You will need to download an enrollment & revalidation checklist based on your Enrollment Type. Find your Provider Type (from step 1) below to determine your Enrollment Type.

Each section below represents an Enrollment Type. Not all Enrollment Types are available for all Provider Types. For example, a Pharmacy only has the option to enroll as a facility, while a Physician may enroll as either a Billing Individual, an Individual Within a Group, or an OPR Provider.

Note that if you are applying as more than one type of provider (Provider Type) your Enrollment Type may be different for each application.

After you have downloaded your enrollment checklist you may move on to step 3.

What is an Enrollment Type?

Your Enrollment Type tells Health First Colorado (Colorado’s Medicaid program) how you want your billing set up and how you want your income from Colorado Medicaid reported to the IRS.

IMPORTANT: If your Provider Type is listed under Atypical, Facility, or Group you MUST select that Enrollment Type on your application.

Enrollment Types

Atypical

  • Behavioral Health Organization (BHO) (31)
  • Case Manager (including Community Centered Boards (CCB) and Intensive Case Managers) (11)
  • Health Maintenance Organization (HMO) (23)
  • Home and Community Based Service (HCBS) provider (This includes all waiver providers i.e. DD, SLS, BI, etc.) (36)
  • Regional Care Collaborative Organization (RCCO) (57)
  • Transportation (73)

Facility

  • Ambulatory Surgery Center (ASC) (44)
  • Dialysis Center (33)
  • Home Health (10)
  • Hospice (50)
  • Hospital - General (01)
  • Hospital - Mental (02)
  • Independent Laboratory (12)
  • Indian Health Services - Pharmacy (62)
  • Nursing Facility (20)
  • Nursing Facility - ICF/IID (21)
  • Optician (08)
  • Personal Care Agency (60)
  • Pharmacy (09)
  • Psychiatric Residential Treatment Facility (30)
  • School Health Services (51)
  • Substance Use Disorder - Clinic (64)
  • Supply (14)
  • Transportation (13)
  • X-Ray Facility (49)

Group

  • Birthing Center (58)
  • Clinic - Dental (47)
  • Clinic - Practitioner (16)
  • Community Mental Health Center (35)
  • Developmental Evaluation Clinic (46)
  • Family Planning Clinic (29)
  • Federally Qualified Health Center (FQHC) (32)
  • Indian Health Services - FQHC (61)
  • Non-Physician Practitioner - Group (25)
  • Rehabilitation Agency (48)
  • Residential Child Care Facility (52)
  • Rural Health Clinic (45)

Individual within a Group

  • Foreign Teaching Physician (65)
  • Non-Physician Practitioner - Individual (24)
  • Physician Assistant (39)

Billing Individual

Billing Individual or Individual Within a Group

The Provider Types below can enroll using either the Billing Individual or Individual Within a Group Enrollment Type. If you're having trouble deciding which of these Enrollment Types is best for you, please review this document: "Billing Individual vs Individual within a Group".

  • Audiologist (19)
  • Certified Registered Nurse Anesthetist (CRNA) (40)
  • Dental Hygienist (66)
  • Dentist (04)
  • Nurse Practitioner (41)
  • Nurse-Midwife (22)
  • Occupational Therapist (28)
  • Optometrist (07)
  • Osteopath (26)
  • Physical Therapist (17)
  • Physician (05)
  • Podiatrist (06)
  • Psychologist - Doctorate (37)
  • Psychologist - Masters (38)
  • Speech Therapist (27)

OPR

If you are applying to join the Colorado Medicaid provider network solely for the purposes of making referrals, you may choose to enroll as an Ordering Prescribing Referring (OPR) provider.

IMPORTANT: OPR providers are only allowed to order, prescribe, or make referrals. OPR providers are not eligible to bill for services rendered.

  • Audiologist (19)
  • Certified Registered Nurse Anesthetist (CRNA) (40)
  • Dentist (04)
  • Nurse Practitioner (41)
  • Nurse-Midwife (22)
  • Optometrist (07)
  • Osteopath (26)
  • Physician (05)
  • Podiatrist (06)
  • Psychologist - Doctorate (37)
  • Speech Therapist (27)