In Colorado, a therapy session for a Medicaid member is usually not billed to the state at all. It goes to one of four Regional Accountable Entities, which have held the Medicaid behavioral health benefit since the Accountable Care Collaborative’s third phase began on July 1, 2025. Add TRICARE West instead of TRICARE East, a telehealth parity law, and a psychotherapy database that includes unlicensed practitioners, and Colorado becomes a state with its own billing rules. Our team bills mental health and psychiatric services for Colorado counselors, therapists, social workers, and group practices, from Denver and Boulder to Colorado Springs, Fort Collins, and the Western Slope.
We bill in twelve states, and Colorado is one of them. Book time with our team or dial 800-820-0364.
Key Colorado Billing Facts
- Medicaid behavioral health belongs to the RAEs. Four regional organizations manage the capitated behavioral health benefit for Health First Colorado members.
- A second regional system covers the uninsured. Behavioral Health Administrative Service Organizations fund safety-net care for people without Medicaid.
- Telehealth pays like in-person care. State-regulated carriers must reimburse telehealth on the same basis as in-person services.
- Clean claims are due in 30 or 45 days. Late payments carry 10% annual interest.
- Military families use TRICARE West. Colorado’s bases fall in the West region, administered by TriWest Healthcare Alliance.
Health First Colorado and the Four RAEs
Health First Colorado, the state’s Medicaid program, runs through the Accountable Care Collaborative. Physical health care is largely paid by the state, but outpatient mental health and substance use care is a capitated benefit managed by a Regional Accountable Entity. Since ACC Phase III launched on July 1, 2025, the state has four regions instead of seven:
- Region 1, Rocky Mountain Health Plans, covering western Colorado.
- Region 2, Northeast Health Partners, covering Larimer, Weld, and the eastern plains, including Logan, Morgan, Otero, Prowers, and Elbert Counties.
- Region 3, Colorado Community Health Alliance, covering Boulder, Broomfield, Jefferson, El Paso, Teller, Park, Clear Creek, and Gilpin Counties.
- Region 4, Colorado Access, covering Denver, Adams, Arapahoe, and Douglas Counties.
A therapist must contract with the RAE for each region where their Medicaid clients live, and each RAE has its own credentialing, authorization, and claims rules. One change in Phase III matters to integrated practices: the short-term behavioral health benefit in primary care, the first six visits that practices had billed to the state, is now billed to the RAE. We confirm each client’s region and RAE before the first session.
BHASOs and the Behavioral Health Administration
Colorado created the Behavioral Health Administration to coordinate the state’s behavioral health system. On July 1, 2025, it launched Behavioral Health Administrative Service Organizations to manage safety-net mental health, crisis, and substance use services for people who are uninsured, underinsured, or not eligible for Medicaid. Rocky Mountain Health Plans serves Region 1, and Signal Behavioral Health Network serves Regions 2, 3, and 4, using the same boundaries as the RAEs. Practices that take this funding follow BHASO requirements separate from their Medicaid and commercial billing, and we keep those streams separate.
Colorado’s Prompt Payment Law
Under C.R.S. 10-16-106.5, carriers must pay, deny, or settle a clean claim within 30 days when it is filed electronically and within 45 days for other submissions. An electronic claim is presumed received on the date the carrier or its clearinghouse verifies receipt, and that confirmation must go back to the provider within one business day. A carrier that misses the deadline owes interest at 10% per year on the total amount ultimately allowed. We keep the receipt confirmations, because they start the clock.
Telehealth Parity in Colorado
C.R.S. 10-16-123 bars state-regulated carriers from denying a covered service because it was delivered by telehealth, and requires them to reimburse participating providers on the same basis as the same service delivered in person. The Colorado Division of Insurance applies that parity to behavioral health and other appropriate services. Each carrier still sets its own place of service and modifier requirements, and a Colorado license generally covers a session only while the client is physically in Colorado, which matters with Wyoming, Nebraska, Kansas, New Mexico, Utah, and other neighbors so close to many practices.
Commercial Coverage and State Employees
Anthem Blue Cross and Blue Shield is Colorado’s Blue plan, and Kaiser Permanente is a major integrated HMO along the Front Range. UnitedHealthcare, Cigna, Aetna, and Denver Health Medical Plan add to the mix, and individual coverage is sold through Connect for Health Colorado, including the standardized Colorado Option plans. Several carriers hand mental health claims to a separate vendor, so we confirm the correct claims address before the first visit. See our insurance verification services.
State of Colorado employees choose between Cigna and Kaiser Permanente plans, while university systems and school districts run their own benefit programs. Kaiser members generally need to see Kaiser-network or referred providers, which is worth confirming before scheduling.
Licensure, Candidates, and the DORA Database
The Division of Professions and Occupations at the Department of Regulatory Agencies licenses LPCs, LMFTs, LCSWs, addiction counselors, and psychologists. Clinicians completing post-degree supervised experience must register as candidates, such as a Licensed Professional Counselor Candidate, a Marriage and Family Therapist Candidate, or a Social Work Candidate, before their hours count. Colorado also requires everyone practicing psychotherapy, including unlicensed psychotherapists, to be listed in the state’s database. Commercial payers generally credential only fully licensed clinicians, and candidate billing rules differ by payer and RAE. We verify each clinician’s credential and each payer’s policy before sessions are billed.
Medicare and TRICARE in Colorado
Novitas Solutions pays Colorado’s Medicare Part B claims under Jurisdiction H, a region that also includes Texas, New Mexico, and Oklahoma. Colorado LPCs and LMFTs have been eligible to enroll with Medicare since January 1, 2024. Colorado is in the TRICARE West region, administered by TriWest Healthcare Alliance since January 1, 2025. Families at Fort Carson, Peterson and Schriever Space Force Bases, the Air Force Academy in Colorado Springs, and Buckley Space Force Base in Aurora make TRICARE West a large share of many caseloads.
Credentialing Colorado Clinicians
A Colorado group may need Health First Colorado enrollment, a contract with the RAE for each region it serves, Anthem, Kaiser, UnitedHealthcare, Cigna, Aetna, TriWest for TRICARE, and Medicare, for every clinician, with updates as candidates become fully licensed. Anything billed before a contract’s effective date is typically treated as out of network or denied. We manage applications, CAQH, and follow-up for every clinician. More detail is on our behavioral health credentialing page. For the Medicaid side, see our Colorado Medicaid provider enrollment guide.
Colorado Denials We See Often
- Wrong RAE on the claim. A client’s county determines the region, and the Phase III map changed some counties.
- Short-term primary care behavioral health billed to the state. Since July 2025 those visits go to the RAE.
- A candidate’s session billed to a commercial payer. Most commercial plans credential only licensed clinicians.
- Kaiser referral or network issues. The member saw a provider outside the Kaiser arrangement.
- TRICARE claims routed to the East region. Colorado belongs to TRICARE West.
- Telehealth paid below the in-person rate. For state-regulated plans, that is worth appealing.
When denials are already stacking up, our claims denial management service works through them.
Colorado by Region
Denver and Aurora practices work with Colorado Access for Medicaid, Kaiser and Anthem for commercial clients, and Buckley families on TRICARE West. Boulder, Jefferson County, and Colorado Springs practices bill Colorado Community Health Alliance for Medicaid, and Colorado Springs adds heavy TRICARE volume from Fort Carson and the Space Force bases. Fort Collins, Loveland, and Greeley practices bill Northeast Health Partners. Grand Junction, Durango, and the mountain communities work with Rocky Mountain Health Plans for both Medicaid and the BHASO. Your billing setup is built around the payers in your part of the state.
What Our Colorado Behavioral Health Billing Includes
- Coverage checks that identify the member’s RAE, commercial behavioral health administrator, Kaiser status, or TRICARE West coverage.
- Claims for intake assessments, individual, couples, family, and group therapy, and psychiatric services.
- Telehealth payments compared against in-person rates.
- Prompt pay tracking from each clearinghouse receipt, with follow-up at 30 and 45 days.
- Credentialing with each RAE and commercial plan, plus updates as candidates become licensed.
- Separate handling for any BHASO-funded services.
Counseling practices can also see our therapy billing services page. Our other state guides cover New Jersey, New York, Pennsylvania, Georgia, North Carolina, Illinois, South Carolina, Connecticut, Missouri, Florida, and Texas.
Frequently Asked Questions
Do we bill Health First Colorado or the RAE for therapy?
For most outpatient behavioral health services, the RAE for the member’s region. We confirm the region and the RAE’s rules for each client.
Can you bill for LPCCs and other candidates?
Where the payer or RAE allows it. Rules vary, so we verify each one before sessions are billed.
Do you handle TRICARE West claims?
Yes. We bill TriWest for Colorado’s military families and keep network status current for each clinician.
Will you use our existing EHR?
Yes. Our billers work in SimplePractice, TherapyNotes, Sessions Health, InSync, and other platforms, so there is nothing new to install.
Hand Off Your Colorado Billing
RAE contracts, TRICARE West, and candidates working toward licensure make Colorado billing different from anywhere else. Contact Maximum Billing or call 800-820-0364 to go over your Colorado payers.