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CODE OF COLORADO REGULATIONS 10 CCR 2505-10 8.100 Medical Services Board

243 8.125.5 PROVIDERS WITH MULTIPLE RISK LEVELS 8.125.5.A Providers shall be screened at the highest applicable risk level for which a provider meets the criteria. Providers shall only pay one application fee per location. 8.125.6 PROVIDERS WITH MULTIPLE LOCATIONS 8.125.6.A. Providers must enroll separately each location from which they provide services. Only claims for services provided at locations that are enrolled are eligible for reimbursement. 8.125.6.B. Each provider site will be screened separately and must pay a separate application fee. Providers shall only pay one application fee per location. 8.125.7 ENROLLMENT AND SCREENING OF PROVIDERS 8.125.7.A. All enrolling and revalidating providers must be screened in accordance with requirements appropriate to their categorical risk level. 8.125.7.B. Notwithstanding any other provision of the Colorado Code of Regulations, providers who provide services to Medicaid members as part of a managed care entity’s provider network who would have to enroll in order to participate in fee- for-service Medicaid must enroll with the Department and be screened as Medicaid providers. 8.125.7.C. Nothing in Section 8.125.7.B shall require a provider who provides services to Medicaid members as part of a managed care entity’s provider network to participate in fee-for-service Medicaid. 8.125.7.D. All physicians or other professionals who order, prescribe, or refer services or items for Medicaid members, whether as part of fee-for-service Medicaid or as part of a managed care entity’s provider network under either the state plan, the Children’s Health Insurance Program, or a waiver, must be enrolled in order for claims submitted for those ordered, referred, or prescribed services or items to be reimbursed or accepted for the calculation of managed care rates by the Department.