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Although every effort is made to ensure the accuracy of this information, discrepancies may occur. The fee schedule may not reflect any changes to rates that occurred after the effective date of the fee schedule. Such changes will be reflected in the next release of the fee schedule.
The Average Acquisition Cost (AAC) rates are used to reimburse pharmacies for covered outpatient drugs. Effective July 1, 2016, Myers and Stauffer is the vendor responsible for determining AAC rates.
If a pharmacy believes that an AAC rate does not accurately reflect the cost of a drug, the pharmacy may request a rate review by submitting a completed AAC inquiry form to Myers and Stauffer.
Pharmacy providers may contact Myers and Stauffer’s toll free help desk line at 800-591-1183 for questions concerning the AAC rates or inquiries.
Current AAC rates are posted on Myers and Stauffer’s website at www.mslc.com/Colorado/.
Additional information regarding the UPL can be found here.
The remainder of the DMEPOS codes can be found under the Health First Colorado Fee Schedule drop-down.
HCBS Waiver Rate Increase Update Memo - October 2017
BI, CMHS, EBD, & SCI (5/17)
ACF/SLP/TLP PETI Form (1/18)
Home Health (04/18)
Home Health (08/16)
Immunization Rates (03/17)
Immunization Rates (10/16)
PETI Audiology Fee Schedule - (See Health First Colorado Fee Schedules section above)
PETI Dental Fee Schedule - (See Health First Colorado Fee Schedules section above)
PETI Vision Fee Schedule
EMT Rates (04/18)
NEMT Rates (04/18)
NEMT Mass Transit Rates (04/18)
EMT Rates (09/16)
NEMT Rates (09/16)
EMT Rates (02/16)
NEMT Rates (02/16)
In 2017 the Department calculated all LTSS HCBS fee-for-service waiver rates utilizing the HCBS rate methodology. The rate methodology and rate setting were required to receive approval of the across the board and targeted rate increases approved by the legislature for FY2017-18. The Department introduced the methodology to stakeholders in May 2017 and solicited feedback on the rate methodology. After the calculation of the rates, stakeholders were provided with the salary and capital inputs used to develop each service rate. The Department solicited feedback on these inputs prior to finalizing the rates. Resources related to the HCBS rate methodology, inputs by service, and the final rates can be found below:
Procedure codes for health care services are updated annually in January to add new codes, remove obsolete codes, update existing codes and replace codes that have changed. Coding Procedure Terminology (CPT) is determined and published by the American Medical Association (AMA), and HCPCS (Healthcare Common Procedure Coding System) is determined and published by Centers for Medicare and Medicaid Services (CMS). The list of code changes is released in the 4th quarter of each year. See the documents below detailing the Rate Methodology for setting new rates for new codes, a crosswalk of: