Colorado RAE Youth Residential Billing: What Providers Should Know
Colorado RAE youth residential billing is changing, but not on the date many providers first heard. Regional Accountable Entities (RAEs) are the regional groups that manage behavioral health benefits for Health First Colorado, the state’s Medicaid program. The state first planned for RAEs to pay for youth residential care starting July 1, 2026. A June 2026 provider bulletin now says that move takes place on July 1, 2027 instead.
What is Colorado RAE youth residential billing?
Colorado RAE youth residential billing is the plan to move payment for certain youth residential treatment from fee-for-service Medicaid to the RAEs. Fee-for-service means the state agency pays claims directly. The Colorado Department of Health Care Policy and Financing (HCPF) runs the program. The change covers Qualified Residential Treatment Programs (QRTPs), Psychiatric Residential Treatment Facilities (PRTFs) and Out-of-State High Intensity Residential Treatment (OHIRT) for youth in county child welfare or Division of Youth Services custody.
What changed, and when does it take effect?
HCPF’s April 2026 provider bulletin said RAEs would reimburse these services starting July 1, 2026. It explained that RAEs had been barred from paying for residential treatment for these youth, and the Department chose to move that care into the RAE benefit. Then the June 2026 bulletin reported a delay under Senate Bill 26-188. It says the transition “will now take place on July 1, 2027.”
Some older pages still show the 2026 date. Treat the newer bulletin as the one to plan from.
Who it affects
Residential programs
QRTPs, PRTFs and OHIRT providers carry the biggest change. They will need to work with the RAE that serves each region once the move happens. Until then, the existing fee-for-service process stays in place.
Outpatient therapists and psychiatrists
For Colorado RAE youth residential billing, outpatient practices sit on the edge. Most solo and group outpatient practices do not bill residential per diems. But you may treat youth before admission or after discharge. Those behavioral health claims already go to the RAE for RAE-covered members, so your routine does not change.
Medicaid billing basics for Colorado RAE youth residential billing
This section covers Medicaid rules only, not private insurance. HCPF’s QRTP billing manual says the facility bills a per diem (a flat daily rate) under code H0019 with modifier U1 and place of service 56. The per diem covers the services in the member’s stabilization and child and family plans. Outside providers may not bill services that the per diem already includes.
The manual also says claims for RAE-covered members go to the RAE. It tells providers to check coverage in the Provider Web Portal. Providers denied RAE enrollment may not bill fee-for-service for RAE-covered services.
What RAEs already require today
A HCPF policy statement effective December 8, 2025 covers care coordination for members under 21 in residential treatment. RAEs coordinate care whoever pays. Providers are asked to tell the RAE of an admission by the close of business the next day. The statement does not set payment responsibility.
What to do Monday morning
- Check each young patient’s coverage with Eligibility Verification in the Provider Web Portal.
- Confirm you are enrolled with Health First Colorado and have a current NPI (National Provider Identifier) on file.
- Confirm your Credentialing with the RAE for your region is current. See our credentialing and network status guide.
- Residential programs: ask your RAE about contracting and Prior Authorization steps before July 1, 2027.
- Do not change your billing yet. Watch HCPF bulletins for new dates.
Where to look next
Our state billing guides collect rules by state. Payer phone numbers and portals are in the insurance companies contact directory. Code questions belong in the CPT and E/M code guide. Psychiatric prescribers should note that E/M visits are billed differently from residential per diems.
The short version: Colorado RAE youth residential billing
Colorado RAE youth residential billing moves residential payment for child welfare youth to the RAEs, now scheduled for July 1, 2027. Until then, follow current HCPF billing rules. Check the latest bulletin before you change anything. Plans for Colorado RAE youth residential billing have already shifted once, and they may shift again.
How MCM South helps
MCM South Medical Billing Service, LLC bills for psychotherapists and psychiatrists in mental and behavioral health, and Colorado is one of our ten currently served states. We can help you check coverage, keep credentialing current and clean up denied claims. See who we serve to find your fit.
Sources checked (November 4, 2026)
- HCPF June 2026 Health First Colorado Provider Bulletin
- HCPF April 2026 Health First Colorado Provider Bulletin
- HCPF Qualified Residential Treatment Program Billing Manual
- HCPF policy statement on RAE care coordination for residential treatment
- HCPF children and youth page
Keep going
Related reading
Frequently asked questions
When do Colorado RAEs start paying for youth residential treatment?
HCPF’s June 2026 provider bulletin says the move from fee-for-service to the RAE behavioral health benefit will now take place on July 1, 2027. It had been scheduled for July 1, 2026. Check HCPF bulletins for any further change.
Which youth residential programs does the change cover?
The April 2026 bulletin names QRTP, PRTF and OHIRT services for youth in county child welfare or Division of Youth Services custody. See the HCPF bulletin.
What code and place of service does a QRTP use for a per diem?
HCPF’s QRTP billing manual lists H0019 with modifier U1 and place of service 56, one unit per day. Always follow the current manual.
Do RAEs already have any role with youth in residential care?
Yes. A policy statement effective December 8, 2025 asks RAEs to coordinate care for members under 21 in residential treatment, whoever pays.
Where MCM South works
MCM South works only in mental and behavioral health. We serve psychotherapists and psychiatrists in solo and medium-size practices across ten currently served states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois. Need a payer contact? Use our insurance companies contact directory.
