Your provider will be able to help answer questions about your Outpatient Physical and Occupational Therapy (PT/OT) services.
You can read about the PT/OT services Health First Colorado (Colorado’s Medicaid program) members can get on our Benefits & Services page.
Physical and Occupational Therapies (PT/OT) are services meant to help you recover from an acute injury, illness, or surgery. Some therapies are meant to help you maintain physical ability, or help children reach developmental milestones.
PT/OT is performed by licensed professionals. Health First Colorado (Colorado’s Medicaid program) limits the number of PT/OT services you can get in a year. Get more information on PT/OT limits.
Health First Colorado (Colorado’s Medicaid program) members who get services through a waiver program have Outpatient Physical and Occupational Therapy covered to the same extent as members who are not enrolled on a waiver program.
The benefit does not have a hard-annual limit for children or adults. The benefit is limited by the number of visits which are authorized.
Your provider will be able to help answer your questions about PT/OT services and how many you are able to get in 12 months.
You can read about the PT/OT services a Health First Colorado (Colorado’s Medicaid program) member can get on the Benefits & Services page.
You can also contact the Health First Colorado Member Contact Center for more information.
Yes. Your primary care doctor, or the hospital you are discharged from, may order or refer you to a physical or occupational therapist to help you recover. You may also go directly to a therapist for care, but that therapist must contact your primary care doctor to get approval for your treatment plan.
Children ages 0 to 3 may receive Outpatient Physical and Occupational Therapy (PT/OT) without a referral if it is coordinated through Early Intervention Colorado.
If you no longer qualify for Health First Colorado or CHP+, you have a limited amount of time to apply for other coverage. The time you have to apply for new coverage, known as a “special enrollment period,” changes depending on the coverage provider.
Other health coverage options include:
If you no longer qualify because you missed the deadline to respond, you can reapply for Health First Colorado. To get free help filling out an application for Health First Colorado or CHP+ coverage, or to learn about other coverage options, call and make an appointment at a certified application assistance site.
Some medications require your doctor to file a prior authorization request before a medication will be covered. Please ask your doctor to contact Health First Colorado (Colorado’s Medicaid program) at 888-672-7203 to request a prior authorization for your medication. Once the prior authorization is submitted, it will take up to 24 hours to process.
Diabetic supplies such as test strips, lancets and syringes are a covered medical benefit and not a pharmacy benefit. Please ask the pharmacy to bill DME-Supplies. Pharmacies can call 1-800-237-0757 if they require additional assistance billing supplies.
A federal rule requires you or an authorized representative to sign your renewal packet.
There are several ways to do this:
A member is allowed to sign with the letter “X” if the signature is witnessed by someone and that witness prints their name after the phrase “witnessed by.”
Important:
When you are approved for Health First Colorado (Colorado’s Medicaid program) or Child Health Plan Plus (CHP+), you only have health coverage for a certain period of time. At the end of your health coverage period, we will review your information to see if you and your household members still qualify for health coverage. An eligibility renewal is sometimes called a redetermination.
Some members will be automatically renewed based on the most recent information already on file with the state. If we need more information to see if you qualify, you will get a renewal packet in the mail and online at CO.gov/PEAK about 60 to 70 days before your renewal deadline.
To keep your health coverage, you must complete your renewal on time.
Watch a short video about how the renewal process works:
