MedicaidPrior AuthMedium impact
Health First Colorado (Colorado's Medicaid Program) News and Updates (B2400517 - 12/2024)
Colorado Medicaid·CO · OB-GYN, Pediatrics, Family Medicine·Provider Bulletin
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Colorado Medicaid (Health First Colorado) released a comprehensive bulletin with multiple updates including coverage expansion for children and pregnant people regardless of immigration status effective January 1, 2025, removal of prior authorization requirements for lab CPT codes 87505 and 87506, and new billing capabilities for lactation services.
Action Required
By January 1, 2025: Billing team must update system to remove prior authorization requirements for CPT codes 87505 and 87506 for laboratory services. Update encounter forms and billing workflows to allow direct billing of lactation services for eligible providers. Prepare for potential increase in Medicaid patient volume due to coverage expansion for children and pregnant people regardless of immigration status.