Telehealth Remote Monitoring Grant Program (Colorado)

Telehealth Remote Monitoring Grant Program (Colorado) is sponsored by Colorado Department of Health Care Policy and Financing. This grant program was created to enable rural Coloradans to benefit from telehealth remote monitoring services. The goal is to improve health outcomes and reduce the time, money, and energy spent on obtaining healthcare.

Colorado State Telehealth Laws - CCHP PLEASE NOTE: CCHP is providing the following for informational purposes only. We are not providing legal advice or interpretation of the laws and regulations and policies. CCHP encourages you to check with the appropriate state agency for further information and direction.

This information should not be construed as legal counsel. Consult with an attorney if you are seeking a legal opinion.

Remote Patient Monitoring: Yes PROFESSIONAL REQUIREMENTS Licensure Compacts: ASLP-IC, CC, DDH, EMS, IMLC, NLC, OT, PA, PSY, PTC, SPC, SW ( View full list of acronym names ) Limited Licensure Exceptions: Yes ( See section for applicable profession and requirements ) Telehealth Specific License/Registration Process: Yes ( See section for applicable profession and requirements ) Consent Requirements: Yes ( See section for applicable profession and requirements ) Originating sites explicitly allowed for Live Video: Yes Distant sites explicitly allowed for Live Video: Yes Store and forward explicitly reimbursed: No Remote patient monitoring explicitly reimbursed: No Audio-only explicitly reimbursed: Yes Allowed to collect PPS rate for telehealth: Yes Medicaid Program: Colorado Medicaid (Health First Colorado) Administrator: Colorado Dept.

of Health Care Policy and Financing Regional Telehealth Resource Center: Southwest Telehealth Resource Center PLEASE NOTE: CCHP is providing the following for informational purposes only. We are not providing legal advice or interpretation of the laws and regulations and policies. CCHP encourages you to check with the appropriate state agency for further information and direction.

This information should not be construed as legal counsel. Consult with an attorney if you are seeking a legal opinion.

Telehealth means a mode of delivery of healthcare services through HIPAA compliant telecommunications systems, including information, electronic, and communication technologies, remote monitoring technologies, and store-and-forward transfers, to facilitate the assessment, diagnosis, consultation, treatment, education, care management, or self-management of a covered person’s health care while the covered person is located at an originating site and the provider is located at a distant site.

SOURCE: CO Revised Statutes 10-16-123(4)(e) . (Accessed Mar. 2026).

Telemedicine means two-way, real time interactive communication between the injured worker and the provider at a distant site. This electronic communication involves, at a minimum, audio and video telecommunications equipment.

Telemedicine enables the remote evaluation and diagnosis of injured workers in addition to the ability to detect fluctuations in their medical condition(s) at a remote site in such a way as to confirm or alter the treatment plan, including medications and/or specialized therapy. SOURCE: CO Permanent Rules, Sec. 7 CCR 1101-3 Rules 1-17 .

(Accessed Mar. 2026).

CO insurers cannot deny coverage solely because the service is provided through telehealth rather than in-person consultation or contact between the participating provider or, subject to section 10-16-704, the nonparticipating provider and the covered person where the health care service is appropriately provided through telehealth; or based on the communication technology or application used to deliver the telehealth services pursuant to this section.

However, use of the word solely, may mean they can find other reasons, such as the service doesn’t meet the appropriate standard of care in the insurer’s view. SOURCE: CO Revised Statutes 10-16-123(2)(b)(II) . (Accessed Mar.

2026).

Subject to all terms and conditions of the health benefit plan or dental plan, a carrier shall reimburse the treating participating provider or the consulting participating provider for the diagnosis, consultation, or treatment of the covered person delivered through telehealth on the same basis that the carrier is responsible for reimbursing that provider for the provision of the same service through in-person consultation or contact by that provider.

SOURCE: CO Revised Statutes 10-16-123(2)(b)(I) . (Accessed Mar. 2026).

According to Revised Bulletin No. B-4. 89, the CO Division of Insurance interprets the above law to require reimbursement for telehealth services at no less than for in-person services, and states that carriers must continue to reimburse providers in parity with in-person rates post-COVID-19 public health emergency.

In addition, the Bulletin states that payment parity applies to all medically necessary covered health care services that are appropriately provided through telehealth, including but not limited to behavioral health, mental health, substance use disorder, occupational therapy, speech therapy, physical therapy services, dental services, and remote monitoring of patients. SOURCE: CO Division of Insurance Policy Directives for Telehealth.

Aug. 18. 2021.

(Accessed Mar. 2026). A health benefit plan or dental plan that is issued, amended or renewed shall not require in-person contact between a provider and a covered person for services appropriately provided through telehealth, subject to all terms and conditions of the health plan or dental plan.

Subject to all terms and conditions of the health benefit plan or dental plan, a carrier shall reimburse the treating participating provider or the consulting participating provider for the diagnosis, consultation, or treatment of the covered person delivered through telehealth on the same basis that the carrier is responsible for reimbursing that provider for the provision of the same service through in-person consultation or contact by the provider.

A carrier shall not restrict or deny coverage solely because the service is provided through telehealth or based on the communication technology or application used to deliver the telehealth services.

A health plan or dental plan is not required to pay for consultation provided by a provider by telephone or facsimile unless the consultation is provided through HIPAA compliant interactive audio-visual communication or the use of a HIPAA compliant application via a cellular telephone.

A carrier shall include in the payment for telehealth interactions reasonable compensation to the originating site for the transmission cost incurred during the delivery of health care services through telehealth except for when the originating site is a private residence.

Impose an annual dollar maximum on coverage for health care services covered under the health benefit plan or dental plan that are delivered through telehealth, other than an annual dollar maximum that applies to the same services when performed by the same provider through in-person care; Impose specific requirements or limitations on the HIPAA-Compliant technologies that a provider uses to deliver telehealth services, including limitations on audio or live video technologies; Require a covered person to have a previously established patient-provider relationship with a specific provider in order for the covered person to receive medically necessary telehealth services from the provider; or Impose additional certification, location, or training requirements on a provider as a condition of reimbursing the provider for providing health care services through telehealth.

SOURCE: CO Statute 10-16-123 . (Accessed Mar. 2026).

Effective January 1, 2027: All large group health benefit plans must provide coverage for the treatment of the chronic disease of obesity and the treatment of pre-diabetes, including coverage for a comparable program to the National Diabetes Prevention Program, medical nutrition therapy, intensive behavioral lifestyle therapy, and metabolic and bariatric surgery.

Intensive behavioral or lifestyle therapy interventions may be provided in-office, virtually through telehealth, or in community-based settings to support patient access and needs. Medical nutrition therapy services may also be provided in-office or virtually through telehealth. SOURCE: CRS 10-16-104 (29) as added by SB 48 (2025 Session) .

(Accessed Mar. 2026). Carrier network adequacy plan reporting requirements include listing providers available through the use of telehealth and addressing how telehealth is used or not used to meet healthcare needs and network adequacy standards.

Mental health parity requirements for health benefit plans reference non-quantitative treatment limitations and the ability to address compliance by expanding the availability of telehealth arrangements to mitigate any overall mental health and substance use disorder provider shortages in a geographic area.

Carriers shall provide a detailed description of efforts to ensure sufficient capacity for and access to Medication Assisted Treatment for Substance Use Disorder, including policies and procedures to assist with telehealth services. SOURCE: 3 CCR 702-4 Series 4-2 . (Accessed Mar.

2026). In addition to the healthcare services listed in Appendix P of CPT, and Division Z- codes (when appropriate), services aligning with the following CPT codes may be provided via telemedicine: G0396, G0397, G0406-G0408, G0425-G0427, G0447, G0459, G0508, G0509, 97129, 97130, 97150, 97542, and 97763. Additional services may be provided via telemedicine with prior authorization.

The provider shall append modifier 95 to the appropriate code(s) to indicate synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system.

All treatment provided through telemedicine shall comply with the applicable requirements found in the Colorado Medical Practice Act and Colorado Mental Health Practice Act, as well as the rules and policies adopted by the Colorado Medical Board and the Colorado Board of Psychologist Examiners and shall follow applicable laws, rules and regulations for informed consent.

HIPAA privacy and electronic security standards are required for the originating site and the rendering provider. The rendering provider may be the only provider involved in the provision of telemedicine services. The rendering provider shall bill place of service (POS) code 02 or 10.

Maximum allowance is the appropriate code’s non-facility relative weight from RBRVS multiplied by the appropriate CF, unless only a facility weight is established. An originating site fee may only be billed when the injured worker is receiving services at an authorized originating site. The originating site is responsible for verifying the injured worker and rendering provider’s identities.

Originating site must bill with the appropriate facility POS code. Authorized originating sites include: A Hospital (inpatient or outpatient) A Critical Access Hospital (CAH) A Rural Health Clinic (RHC) A federally qualified health center (FQHC) A hospital based renal dialysis center (including satellites) A Skilled Nursing Facility (SNF) A community mental health center (CMHC) Maximum allowance for Q3014 is $35. 70 per 15 minutes.

(Equipment, supplies, and professional fees of supporting providers at the originating site are not separately payable.) Documentation requirements are the same as for a face-to-face encounter and shall also include the location of both the rendering provider and the injured worker at the time of service, and a statement on how the treatment was rendered through telemedicine (such as secured video).

Treating Physician Telephone or On-line Services – Minimum required documentation elements include: (a) Total time spent on medical discussion and date; (b) The injured worker, family member, or healthcare provider spoken with; and (c) Specific discussion and/or decision(s) made during the discussion. Telephone or on-line services may be billed even if performed within the one day and seven day timelines listed in CPT®.

Reimbursement for coordination of care between medical professionals is limited to professionals outside of the Provider’s practice. Telephone services, including those listed in Appendix T and Telephone Services section of CPT®, shall be billed with a modifier 93. Modified RVUs are also listed.

Teledentistry – Synchronous and asynchronous teledentistry codes are also included on the Dental Fee Schedule within the workers’ compensation system. SOURCE: CO Permanent Rules, Sec. 7 CCR 1101-3 Rule 18 & Exhibits .

(Accessed Mar. 2026).

A health-care or mental health-care provider who delivers health-care or mental health-care services through telemedicine shall provide to each patient, before treating that patient through telemedicine for the first time, the following written statements: That the patient retains the option to refuse the delivery of the services via telemedicine at any time without affecting the patient’s right to future care or treatment and without risking the loss or withdrawal of any program benefits to which the patient would otherwise be entitled; That all applicable confidentiality protections shall apply to the services; and That the patient shall have access to all medical information resulting from the telemedicine services as provided by applicable law for patient access to his or her medical records.

This subsection shall not apply in an emergency. SOURCE: CO Revised Statutes 25. 5-5-320 .

(Accessed Mar. 2026). For initial visits, providers must comply with the requirements posted under Waiving the Face-to-Face Requirement & Required Disclosure Statements .

For each subsequent visit, providers must document the member’s consent, either verbal or written, to receive telemedicine services. Waiving the Face-to-Face Requirement & Required Disclosure Statements The Health First Colorado requirement for an initial face-to-face contact between provider and member may be waived when treating the member through telemedicine.

In-person contact between a health care provider and a member is not required for services delivered through telemedicine that are otherwise eligible for reimbursement.

Prior to treating the member through telemedicine for the first time, the provider must furnish each member with all of the following written statements, which must be signed (electronic signatures will be accepted) by the member or the member’s legal representative: The member retains the option to refuse the delivery of health care services via telemedicine at any time without affecting the member’s right to future care or treatment and without risking the loss or withdrawal of any program benefits to which the member would otherwise be entitled.

All applicable confidentiality protections shall apply to the services. The members shall have access to all medical information resulting from the telemedicine services as provided by applicable law for member access to his or her medical records. [C.

R. S. 2018, 25.

5-5-320 (4)]. These requirements do not apply in an emergency. [C.

R. S. 2018, 25.

5-5-320 (5)]. SOURCE: CO Department of Health Care Policy and Financing. “Telemedicine Billing Manual” 3/26 .

(Accessed Mar. 2026). Covered telemedicine services must be provided only after the member’s consent, either verbal or written, to receive telemedicine services is documented.

SOURCE: CO Adopted Rule 8. 095. 4.

A . (Accessed Mar. 2026).

All consent for telemedicine services could be verbal during the PHE. Providers must obtain written consent prior to the first visit post-PHE, as described in the Waiving the Face-to-Face Requirement & Required Disclosure Statements section of the Telemedicine Billing Manual . SOURCE: CO Dept.

of Health Care Policy and Financing, Provider Bulletin, June 2023. (Accessed Mar. 2026).

Home and Community Based Services (HCBS) HCBS waiver providers shall ensure the use of HCBS Telehealth is the choice of the Member. The HCBS waiver provider shall maintain a consent form for the use of HCBS Telehealth in the Member’s record. SOURCE: CO Adopted Rule 8.

615. 4 ; 8. 7559 .

(Accessed Mar. 2026). When Remote Supports includes the use of live audio and/or video equipment that permits a Remote Supports Provider to view activities and/or listen to conversations in the residence, the Client who receives the service and each person who lives with the Client shall consent in writing after being fully informed of what Remote Support entails.

See rule for additional details. SOURCE: CO Adopted Rule 8. 488.

40 . (Accessed Mar. 2026).

Early Childhood Intervention Program Service coordinators shall ensure individualized family service plans include parental consent for telehealth methods of service. SOURCE: CO Adopted Rule 5. 113 .

(Accessed Mar. 2026).

Telemedicine means the delivery of medical and health-care services and any diagnosis, consultation, or treatment using interactive audio (including but not limited to telephone and relay calls), interactive video (including but not limited to interactive audiovisual modalities), or interactive data communication (including but not limited to live chat and excluding text messaging, electronic mail, and facsimile transmission).

SOURCE: Colorado Adopted Rule 8. 095. 1.

A . (Accessed Aug. 2026).

Telemedicine is not a unique service, but a means of providing services approved by Health First Colorado through live interactive audio and video telecommunications equipment. SOURCE: CO Department of Health Care Policy and Financing. “Telemedicine Billing Manual.

”, Updated 7/20/26 , (Accessed Aug. 2026). “ Telemedicine ” means the delivery of medical and health-care services and any diagnosis, consultation, or treatment using interactive audio, interactive video, or interactive data communication.

SOURCE: Colorado Revised Statute 25. 5. -4-103 (25.

7) (Accessed Aug. 2026). Telehealth Remote Monitoring Services include the installation and on-going remote monitoring of clinical data through technologic equipment in order to detect minute changes in the member’s clinical status that will allow Home Health agencies to intercede before a chronic illness exacerbates requiring emergency intervention or inpatient hospitalization.

SOURCE: CO Medical Assistance Program, Home Health Billing Manual, (7/26), (Accessed Aug. 2026). Telehealth allows for the monitoring of a member’s health status remotely via equipment, which transmits data from the member’s home to the member’s home health agency.

The purpose of providing telehealth services is to assist in the effective management and monitoring of members whose medical needs can be appropriately and cost-effectively met at home through the frequent monitoring of data and early intervention. SOURCE: CO Department of Health Care Policy and Financing. “Home Health Telehealth”.

(Accessed Aug. 2026). Telehealth means the broad use of technologies to provide services and supports through HCBS waivers, when the Member is in a different location from the provider.

SOURCE: Colorado Adopted Rule 8. 615. 1 (M) .

(Accessed Aug. 2026). Telehealth means the provision of health care remotely using telecommunications technologies to provide approved services and supports through HCBS waivers when the Member is in a different location from the provider.

SOURCE: 10 CCR 2505-10, Section 8. 7402 . (Accessed Aug.

2026). Early Childhood Intervention Program Telehealth means a method of service provision that utilizes secure interactive videoconferencing to deliver early intervention services. SOURCE: 8 CCR 1405-1, Section 5.

103 . (Accessed Aug. 2026).

“Telehealth” means delivery of services through telecommunications systems that are compliant with all federal and state protections of individual privacy, to facilitate individual assessment, diagnosis, consultation, treatment, and/or service planning/case management when the individual and the person providing services are not in the same physical location.

Telecommunications systems used to provide telehealth include information, electronic, and communication technologies. Telehealth may include audio-only methods in accordance with state and federal regulation unless noted otherwise. SOURCE: 2 CO Code of Regulation 502-1, 1.

2 . (Accessed Aug. 2026).

Program of All-Inclusive Care for the Elderly (PACE) Telehealth means a mode of delivery of health care services through HIPAA-compliant telecommunications systems, including information, electronic, and communication technologies, remote monitoring technologies and store-and-forward transfers, to facilitate the assessment, diagnosis, consultation, treatment, education, care management, or self-management of a covered person’s health care while the covered person is located at an originating site and the provider is located at a distant site.

SOURCE: 10 CCR 2505-10, Section 8. 497 . (Accessed Aug.

2026). Telemedicine may be provided through interactive audio, interactive video, or interactive data communication, including but not limited to telephone, relay calls, interactive audiovisual modalities, and live chat, as long as the technologies are compliant with the federal “Health Insurance Portability and Accountability Act of 1996”, Pub. L.

104-191, as amended. The health-care or mental health-care services are subject to reimbursement policies developed pursuant to the medical assistance program. The reimbursement rate for a telemedicine service shall, as a minimum, be set at the same rate as the medical assistance program rate for a comparable in-person service.

The state department may consider setting the reimbursement rate on a monthly basis as well as on a daily or per-visit basis. SOURCE: CO Revised Statutes 25. 5-5-320 .

(Accessed Mar. 2026). Telemedicine is not a unique service, but a means of providing services approved by Health First Colorado through live interactive audio and video telecommunications equipment.

Telemedicine services may be provided under two arrangements: A member receives services via a live audio/visual connection from a single provider; or A member and a provider are physically in the same location and additional services are provided by a second (distant) provider via a live audio/visual connection.

In this arrangement the provider who is present with the member is the originating provider, and the provider located at a different site, acting as a consultant, is called the distant provider. The member must be present during telemedicine visits. Providers should refer to the Code of Colorado Regulations Program Rules (10 CCR 2505-10, Section 8.

095), for specific information when providing telemedicine services. See provider manual for covered procedure codes. All rendering providers must bill the appropriate procedure code using Place of Service code 02 or 10 and the appropriate modifiers FQ, FR, 93 or 95 on the CMS 1500 paper claim form or as an 837P transaction.

Telemedicine does not include provider-to-provider consultations provided by telephone (interactive audio), email or facsimile machines. 93: Synchronous Telemedicine Service Rendered Via Telephone or Other Real-Time Interactive Audio-Only Telecommunications System FQ: The service was furnished using audio-only communication technology.

Health First Colorado allows telemedicine visits to qualify as billable encounters for Federally Qualified Health Centers (FQHCs), Rural Health Clinic (RHCs), and Indian Health Services (IHS). Services allowed under telemedicine may be provided via telephone, live chat, or interactive audiovisual modality for these provider types.

When a Federally Qualified Health Center (FQHC) or a Rural Health Clinic (RHC) provides care through telemedicine, the claim must include the modifier GT on line(s) identifying the service(s). The claims must follow the other requirements of an FQHC or RHC claim as identified in the FQHC and RHC Billing Manual . SOURCE: CO Department of Health Care Policy and Financing.

“Telemedicine Billing Manual” 3/26 . (Accessed Mar. 2026).

“Telehealth” means delivery of services through telecommunications systems that are compliant with all federal and state protections of individual privacy, to facilitate individual assessment, diagnosis, consultation, treatment, and/or service planning/case management when the individual and the person providing services are not in the same physical location.

Telecommunications systems used to provide telehealth include information, electronic, and communication technologies. Telehealth may include audio-only methods in accordance with state and federal regulation unless noted otherwise. “Session” means a face-to-face, telehealth, or audio-only interaction of the individual and personnel.

Session may include but is not limited to individual therapy, group therapy, medication-assisted treatment education and/or monitoring, family therapy, peer professional services, educational/occupational groups, recreational therapy, intake, discharge, service planning, and other therapies. Services may be provided through synchronous audio-visual methods but must not include text-only methods such as text message or email.

Some services may be provided through audio-only methods according to state and federal regulations. If audio-only methods are used, the following must be noted in the individual record: The reason that audio-visual methods were not utilized. The clinical determination of appropriateness for service delivery method.

Screenings should be conducted in-person unless contraindicated. If contraindicated, screenings may be conducted via audio-visual or audio only telehealth. Clinical rationale must be documented in the case of a telehealth screening.

A peer support professional may provide services in a variety of settings, if permitted access, that may include but are not limited to audio-visual or audio-only telehealth. Outpatient services may be delivered via in-person, audio-visual telehealth, or audio-only telehealth format in accordance with part 2. 9 of these rules.

For purposes of Criminal Justice-Involved Individuals, services do not include consistent and regular in-session use of audio-only telehealth. “Face-to-Face clinical assessment” means a formal and continuous process of collecting and evaluating information about an individual for service planning, treatment, referral, and funding eligibility as outlined in 21.

190, and takes place at a minimum upon a request from the responsible person for funded services through the Children and Youth Mental Health Treatment Act. This information establishes justification for services and Children and Youth Mental Health Treatment Act funding. The child or youth must be physically in the same room as the professional person during the Face-to-Face clinical assessment.

If the child is out of state or otherwise unable to participate in a Face- to-Face assessment, video technology may be used. If the Governor or local government declares an emergency or disaster, telephone may be used. Telephone shall only be used as necessary because of circumstances related to the disaster or emergency.

SOURCE: 2 CO Code of Regulation 502-1, 1. 2, 2. 9, 2.

12. 1, 4. 3.

1, 3. 2, 10. 1, 21.

200. 41 . (Accessed Mar.

2026). Screening Brief Intervention Treatment Screening Brief Intervention Treatment may be provided via telemedicine (simultaneous audio and video transmission or by telephone audio-only) with the member. SOURCE: CO Department of Health Care Policy and Financing.

“Screening, Brief Intervention and Referral to Treatment”, 5/25. (Accessed Mar. 2026) .

Upon department approval, certain eligibility determinations, assessments, referrals, and monitoring contacts may be completed by case managers at an alternate location, via telephone or using virtual technology methods. Such approval may be granted for situations in which face-to-face meetings would pose a documented safety risk to the case manager or Client (e.g. natural disaster, pandemic, etc.). SOURCE: 10 CCR 2505-10 8.

501; 8. 506. 4.

B; 8. 508. 70; 8.

509; 8. 519 ; 8. 7202; 8.

7560 . (Accessed Mar. 2026).

Telehealth Adult Day Services are provided through virtual means in a group or on an individual basis. Telehealth ADS are ways for participants to engage in activities, with their community, and connect to staff and other ADS participants virtually or over the phone, only if a participant does not have access or the ability to use video chat technology. Services provided through Telehealth are not required to provide nutrition services.

See rules for staffing, documentation, and written policy requirements specific to use of telehealth ADS. SOURCE: 10 CCR 2505-10 8. 7505 .

(Accessed Mar. 2026). Home Health Services & Family Planning Services Eligible places of service include telemedicine, provided in accordance with Section 8.

095. SOURCE: Colorado Adopted Rule 8. 520.

4. B. g ; Colorado Adopted Rule 8.

730. 3. B .

(Accessed Mar. 2026).

Prenatal Plus Visit Definition: A visit includes a one-on-one or face-to-face encounter, or an interactive audio, interactive video, or interactive data communication encounter in accordance with program requirements and telemedicine guidelines, between a PN+ program participant (HFC member) and a member of the participating PN+ site care team including a case manager/care coordinator, a registered dietitian, or a mental health provider.

The following scenarios are not considered a countable visit for any PN+ package type: Calls to reschedule an appointment or to make an appointment with a member. Messaging with a member, though a provider may choose to communicate with members in a HIPAA compliant messaging platform as part of their practice. The PN+ program allows for approved PN+ locations to use telemedicine to conduct most requirements of the program.

There should be at least one in-person visit throughout the course of the member’s participation in the program; exceptions can be made on a case-by-case basis if the member has identified barriers to coming in-person to the PN+ site and the member requests services through a telemedicine platform. Refer to the Telemedicine and eConsult Billing Manual for required Place of Service Codes that you must include in your claim.

If you are an FQHC using telemedicine for visits, please note there is an additional modifier required. SOURCE: CO Dept. of Health Care Policy and Financing, Prenatal Plus Program, Last revised 1/27/26 .

(Accessed Mar. 2026). Services for which Health First Colorado assistance is not available include, but are not limited to: Psychiatric services refer to services described in CPT under the heading “Psychiatry”.

Health First Colorado benefits are available for face-to-face member contact services only. Benefits are not available for report preparation, telephone consultation, case presentations, or staff consultation. Psychiatric providers may not bill for: SOURCE: CO Dep.

of Health Care Policy and Financing, Medical-Surgical Billing Manual, Last revised 3/18/26, (Accessed Mar. 2026). Rural travel add-ons may be billed for Members residing in counties designated as rural or frontier.

Rural add-on may not be billed in conjunction with telephone/virtual monitoring. This work includes monitoring the effective and efficient provision of services across multiple funding sources. Targeted case management via telephone and video is listed as allowed.

See manual. SOURCE: CO Dep. of Health Care Policy and Financing, Home and Community-Based Services for Persons with Intellectual and/or Developmental Disabilities Waiver Programs & Targeted Case Management for Home and Community-Based Services Waiver Programs, Last revised 10/22/25, (Accessed Mar.

2026). Telemedicine services may be provided under two arrangements: A member receives services via a live audio/visual connection from a single provider; or A member and a provider are physically in the same location and additional services are provided by a second (distant) provider via a live audio/visual connection.

In this arrangement the provider who is present with the member is the originating provider, and the provider located at a different site, acting as a consultant, is called the distant provider. The member must be present during telemedicine visits. Providers should refer to the Code of Colorado Regulations Program Rules (10 CCR 2505-10, Section 8.

095), for specific information when providing telemedicine services. When a Federally Qualified Health Center (FQHC) or a Rural Health Clinic (RHC) provides care through telemedicine, the claim must include the modifier GT on line(s) identifying the service(s). The claims must follow the other requirements of an FQHC or RHC claim as identified in the FQHC and RHC Billing Manual .

It is acceptable to use telemedicine to facilitate live contact directly between a member and a provider. Services can be provided between a member and a distant provider when a member is in their home or other location of their choice. Additionally, the distant provider may participate in the telemedicine interaction from any appropriate location.

Other standard requirements for telemedicine services include: The reimbursement rate for a telemedicine service shall, as a minimum, be set at the same rate as the medical assistance program rate for a comparable in-person service. [C. R.

S. 2017, 25. 5-5-320(2)].

Providers may only bill procedure codes which they are already eligible to bill. Any health benefits provided through telemedicine shall meet the same standard of care as in-person care. For initial visits, providers must comply with the requirements posted under Waiving the Face-to-Face Requirement & Required Disclosure Statements .

For each subsequent visit, providers must document the member’s consent, either verbal or written, to receive telemedicine services. Contact with the provider must be initiated by the member for the service rendered.

The availability of services through telemedicine in no way alters the scope of practice of any health care provider, nor does it authorize the delivery of health care services in a setting or manner not otherwise authorized by law. Services not otherwise covered by Health First Colorado are not covered when delivered via telemedicine.

The use of telemedicine does not change prior authorization requirements that have been established for the services being provided. Record-keeping and patient privacy standards should comply with normal Medicaid requirements and HIPAA. The Health First Colorado requirement for an initial face-to-face contact between provider and member may be waived when treating the member through telemedicine.

In-person contact between a health care provider and a member is not required for services delivered through telemedicine that are otherwise eligible for reimbursement. Prior to treating the member through telemedicine