Supplemental Payments for Eligible Primary Care Physicians

Primary Care Provider Self Attestation Information 

Changes to Medicaid primary care reimbursement were enacted as part of the Affordable Care Act. Eligible physicians will receive supplemental payments for services rendered between January 1, 2013, and December 31, 2015, that raise the Medicaid reimbursement to Medicare rates.

To be eligible for the increased payment, physicians must personally attest as practicing in family medicine, general internal medicine and/or pediatric medicine and be board certified or meet thresholds for providing recent primary care services. Advanced practice professionals practicing under the personal supervision of a qualified physician are eligible to receive the supplemental payment.

Providers must fill out the short Self-Attestation Form in order to be eligible for the supplemental payments.

Supplemental payments will be from the date of self-attestations.

Self-Attestation Form

FAQs

Fact Sheet

Supplemental Payment Physician Fee Schedule CY 2013

Supplemental Payment Physician Fee Schedule CY 2014

Upcoming Payment News

The Department anticipates that a quarterly supplemental payment for April - June 2014 was made late September 2014. This payment will be labeled “Supplemental” on your payment remittance. Note: Amounts are based on paid claims, not dates of service. 

Primary Care Supplemental Payments
As part of Colorado Medicaid’s effort to maintain or increase access to medical care, the Department has committed to reimbursing primary care E&M codes (office visits) at Medicare’s December 2014 rate through at least CY2015. The federal program under which primary care providers received quarterly lump sum payments based on E&M claims is ending December 31, 2014.  Reimbursement of E&M codes at the Medicare rate in CY2015 will be funded by a combination of state and federal funds. This represents a $40 million annual expenditure.