The Department of Health Care Policy and Financing (HCPF) wants to provide an update regarding Medicaid reimbursement for Community Health Worker (CHW) services. Due to the State’s budget shortfall, the Colorado General Assembly passed legislation (SB 25-229) that postpones CHW Medicaid reimbursement until January 1, 2026. The Medicaid reimbursement for CHW services will not begin on July 1, 2025, but will instead begin on January 1, 2026.
While the CHW benefit will be paused for at least six months, HCPF would like to provide you with some additional Health First Colorado resources. For community-based organizations (CBOs) and medical providers with CHWs on staff, HCPF recommends reaching out to your respective Regional Accountable Entity (RAE) for any collaboration opportunity for CHW services. RAE contracts encourage RAEs to develop a network of CBOs to support care coordination work and to prioritize CBOs that employ CHWs.
For medical providers that are currently enrolled with HCPF, the following are Medicaid resources that may be of interest:
- Vaccine Hesitancy Counseling
- Diabetes Self-Management Education Services (DSMES)
- Tobacco Cessation
- Screening, Brief Intervention, and Referral to Treatment (SBIRT)
If you are interested in any additional information or have questions about the CHW benefit being paused until January 1, 2026, please reach out to HCPF_CHW_Benefit@state.co.us.
Source: Department of Health Care Policy and Financing (HCPF)
In order for a CHW to qualify for Medicaid reimbursement, they must take training from a recognized training program and pass an assessment. For more information on the training pathway offered through PNCT, visit our page on the Colorado CHW Registry.