DATA RESCUE 6 MAC UPDATE
DATA RESCUE 6 MAC PLUS

A rate list is effective until another list is posted by Myers and Stauffer the following week.The AAC rate list is monitored and maintained weekly to account for changing market prices.Average Acquisition Cost (AAC)ĪAC rates are used to reimburse pharmacies for covered outpatient drugs, including clotting factor drugs effective April 1, 2022, and Myers and Stauffer is the contractor responsible for maintaining the AAC rates. For outpatient pharmacy coverage information go to the Pharmacy Resources webpage. Please note that these are published rates only and do not reflect the coverage status for any prescription drugs. The below rates are used in the outpatient pharmacy reimbursement methodology. July 2018 Outpatient Substance Abuse Fee Schedule July 2019 Outpatient Substance Abuse Fee Schedule July 2020 Outpatient Substance Abuse Fee Schedule July 2021 Outpatient Substance Abuse Fee Schedule July 2022 Outpatient Substance Abuse Fee Schedule Outpatient Substance Abuse Fee Schedule 2022 Immunization Rate Schedule Fiscal Year (2023-2024) Fiscal Year 2023-2024Ĭlinical Diagnostic Laboratory Rates - FY 2023-2024Ĭlinical Diagnostic Laboratory Rates – effective

Rates are effective September 1, 2022, and will be updated annually by July 1. These rates are the maximum that can be charged for hospital services under Hospital Discounted Care. Rates approximate 100% of Medicare or 100% of Medicaid, whichever is greater. Hospital Discounted Care limits the cost of hospital care for low income, uninsured Coloradans receiving services through hospitals’ financial assistance. Hospice Fee Schedule Fiscal Year (2022 - 2023) HCBS American Rescue Plan Act (ARPA) Rate Schedule Rates Effective HCBS Rates Breakout - Denver (effective July 1, 2023).HCBS Rates Breakout - Non-Denver (effective July 1, 2023).Office of Community Living (OCL) Acronym Glossary.Email notification about the 2021 Denver Minimum Wage Rate Increase.

DATA RESCUE 6 MAC UPDATE

HCBS Waiver Rate Increase Update Memo - 2021.This section opens on a new page and contains information on annual rate increases, HCBS rate increases, HCPCS rates and State Plan XIX. The remainder of the DMEPOS codes can be found under the Health First Colorado Fee Schedule. Durable Medical Equipment Fee Schedule (2018)Īdditional information regarding the UPL can be found in this letter to providers.Durable Medical Equipment Fee Schedule (2019).

Durable Medical Equipment Fee Schedule (2020).

Durable Medical Equipment Fee Schedule (2021).

Durable Medical Equipment Fee Schedule (2022).

Durable Medical Equipment Fee Schedule (2023).

Below is the fee schedule for the codes that fall within the scope of the DME UPL. The Department is referring to this requirement as the DME Upper Payment Limit (UPL). Health First Colorado is required to comply with the Consolidated Appropriations Act of 2016 (Section 503) which means Health First Colorado cannot pay more than what Medicare would have paid in the aggregate for certain DME services.

Clinical Diagnostic Laboratory Test (CDLT) Rate Tracking Sheet (2018.7-2021.7)ĭialysis Rate Schedule Fiscal Year (2023-2024)ĭurable Medical Equipment, Upper Payment Limit.

Clinical Diagnostic Laboratory Test (CDLT) Rate Tracking Sheet (2020.7 - 2022.7).

Clinical Diagnostic Laboratory Test (CDLT) Rate Tracking Sheet (2021.7 -2023.7).

Below is the rate tracking sheet for CDLT UPL codes: These requirements can be found in section 1903(i)(7) and section 1833(h) of the Social Security Act. PAMA enacted changes to the Medicare CLFS and required that Medicaid payments for CDLTs not exceed the Medicare allowed amount for the same CDLTs. In order to comply with the Protecting Access to Medicare Act (PAMA), Health First Colorado will adjust Clinical Diagnostic Laboratory Test (CDLT) rates on a per-test basis to align with Medicare's quarterly release of Clinical Laboratory Fee Schedule (CLFS) rates.

DATA RESCUE 6 MAC PLUS

List of All ASC Codes and Respective Groupers Fiscal Year (2023-2024)Ĭhild Health Plan Plus Fee-for-Service (FFS) RatesĬhild Health Plan Plus Specialty Drug Guidance Clinical Diagnostic Laboratory Test, Upper Payment Limit January 2018 Fee Schedule Data File (06/18)Īmbulatory Surgical Centers (ASC) Rate Schedule January 2018 Fee Schedule Instructions (03/18) Such changes will be reflected in the next release of the fee schedule. The fee schedule may not reflect any changes to rates that occurred after the effective date of the fee schedule. Although every effort is made to ensure the accuracy of this information, discrepancies may occur.

Data rescue 6 mac