Medicaid Colorado – Incorrect Member Billing for COVID-19 Tests and Co-Pay Amounts

Providers are reminded that members cannot be billed for the covered COVID-19 tests, including rapid tests. Visit the COVID-19 Information for Health First Colorado and CHP+ Providers and Case Managers web page for the covered codes listed in the COVID-19 Coding Information section.

Providers are instructed to not collect co-pay amounts from any Health First Colorado (Colorado’s Medicaid Program) member for the following types of visits related to COVID-19:

• Visits where any Advisory Committee on Immunization Practices (ACIP)-recommended vaccine is administered. This includes COVID-19 vaccine administration.
• Visits where a COVID-19 diagnostic test is performed.
• Visits where treatment is provided to a member diagnosed with COVID-19. 

Claims for these visits will not have a co-pay deducted for members who are otherwise responsible for cost-sharing. Visit the General Provider Information Manual for more information on the co-pay policy.

Source: https://www.colorado.gov/hcpf/covid-19-provider-information#coding