Article Index
Colorado Provider Status and Payment for Services
Colorado Pharmacist Services Billing Guide
Medicare
Medicaid
Private/Commercial
Cash
Suggested Initial Billing Process Steps
Provider Status Training Resources
Additional Resources
All Pages

Medicaid:

Authority: Pharmacists in Colorado can enroll in Medicaid as medical providers and bill for certain services. The services covered include any care provided as part of Part 6 of the Practice Act. This includes collaborative practice agreements, collaborative drug therapy management (CDTM) and statewide drug therapy protocols, or SWPs). The bill that authorizes this was passed by CPS in 2021 and can be found here: HB 21-1275.

Colorado Medicaid has produced a comprehensive billing guide that is updated regularly with any changes. This manual should serve as the primary resource for all pharmacists who wish to bill Medicaid for services. This includes how to enroll, what services are covered and billable codes.
Colorado Medicaid Pharmacists Services Billing Manual


Medicaid Codes and Billing for Pharmacists
The Colorado Pharmacists Society (CPS) created this document, updated in October 2024, to provide Colorado pharmacists with a comprehensive and convenient resource for Medicaid billing. By consolidating essential billing codes, fee schedules, and procedural descriptions into a single document, CPS aims to make it easier for pharmacists to navigate Medicaid billing for various services, including immunizations, screenings, and chronic care management. Users are advised to consult the official Colorado HCPF Pharmacists Services Billing Manual for further details.

Advocacy Asks: Continue to evaluate the breadth of this coverage. Ideally, payment would be for any services provided under a pharmacist's scope of practice, which we will continue to advocate for.

More information can be found under the Colorado Pharmacist Services Billing Guide section.