Behavioral Health Rate Reform

The Department is in the process of reforming the behavioral health rate-setting process. 

The Department hires contractors to assist in development and updating of documents for the Behavioral Health Capitated Entities Organizations (BH RAEs), Community Mental Health Centers (CMHCs), and the Department. The Department, the BH RAEs, and the CMHCs will use the documents for rate-setting.

The final documents are a collaboration of feedback from the Department, the Office of Behavioral Health (OBH), and other stakeholders. The Department anticipates that further changes will be made to the posted documents and will set up a working group to provide input when updating the documents. The links to the these documents are below for reference and use by the provider community, interested stakeholders, and the Department.

Annual Cost Report

FY18 Cost Report Template
This document updates the billable costs to Medicaid and OBH. Additionally, this document requires the CMHCs and RAEs report costs in greater detail. The FAQ provides answers to the questions and recommendations developed by the providers during the March 2010 cost trainings and the A&A Review Committee.

Uniform Service Coding Standards

This document sets forth the requirements of billing procedure codes for behavioral health services covered by the Department and the Office of Behavioral Health. 

Uniform Services Coding Standards July 2018
Uniform Services Coding Standards Addendum February 2018
Uniform Services Coding Standards January 2018
Uniform Service Coding Standards July 2017
Uniform Service Coding Standards Addendum March 2017

Uniform Service Coding Standards January 2017
Uniform Service Coding Standards October 2016

Uniform Service Coding Standards July 2016
Uniform Service Coding Standards 2015

July 2018 Code Manual Changes Form
January 2018 Code Manual Changes Form
July 2017 Code Manual Changes Form
January 2017 Code Manual Changes Form

October 2016 Code Manual Changes Form
July 2016 Code Manual Changes Form

The USCS manual is a living document that is updated periodically to maintain consistency between the BH RAE contracts, the OBH Contract, the State Plan Amendments, the 1915(b)(3) waiver, and coding guidelines. 

If you have any questions regarding any of these documents please contact John Doherty at john.doherty@state.co.us