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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. 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 about Medicaid billing can also be found in the Pharmacist Services Billing Guide for Colorado. |
