Primary Care Medicaid Rates 16/17

You may recall the Governor's proposed FY 2016-17 budget did not include the continuation of the enhanced payments for Medicaid primary care services. However, thanks to the grassroots advocacy, media efforts, and direct lobbying of the Colorado Primary Care Alliance (a coalition of 20+ organizations), within the last couple of weeks the Legislature has authorized the transfer of $20 million in funds for the continuation of rate enhancements (87.3% of Medicare) for the following selected codes:

• Office Visit  (99201-99205, 99211-99215)
• Preventive Medicine visits  (99381-99397)
• Newborn (99460-99465, 99477-99486) 
• Immunization Administration (90460-90461, 90471-90474)
• Counseling and Health Risk Assessments (99401-99414, 99417-99429)
• Critical Care Visit - Neonatal and Pediatric (99466-99476)

These funds are one-time and not built into the Medicaid rate base. Be sure to read HCPF's May 2016 Provider Bulletin for an official announcement!  The Alliance will be meeting to debrief on this year’s efforts and develop a go-forward strategy for FY 2017-18. Thank you to the many ClinicNET affiliates and partner organizations that participated in the advocacy efforts!

Questions? Contact Brooke Powers at brooke.powers@clinicnet.org