How to become a Medicaid provider in Colorado
To bill Colorado Medicaid, enroll through Colorado interChange Provider Web Portal (Gainwell), run by Gainwell Technologies. The process has 5 steps, listed below with the documents the state asks for.
- Enrollment portal
- Colorado interChange Provider Web Portal (Gainwell)
- Steps
- 5
- Documents
- 6
- Plans listed
- 6
On this page
Colorado Medicaid enrollment at a glance
To bill Colorado Medicaid, enroll through Colorado interChange Provider Web Portal (Gainwell), run by Gainwell Technologies. The process has 5 steps, listed below with the documents the state asks for.
- Program
- Health First Colorado (Colorado Medicaid)
- Enrollment portal
- Colorado interChange Provider Web Portal (Gainwell)
- Fiscal agent
- Gainwell Technologies (Colorado interChange MMIS)
- Application fee
- HCPF lists the CY2026 fee as $750 for institutional providers, charged on new enrollments, revalidations and new locations. HCPF also has a process for paying a previously waived fee. Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.
- Fingerprinting
- HCPF names its high-risk types, all for new enrollments: doulas, DME suppliers, home health agencies, hospices, lactation providers, skilled nursing facilities, personal care agencies under the state plan, certain opioid treatment providers, and some HCBS providers. Those providers and their 5%+ owners must be fingerprinted within 30 days of a request. Federal rule (42 CFR 455.434, 455.450(c)): providers the state places in the 'high' categorical risk level, and anyone owning 5% or more of such a provider, must submit fingerprints for a criminal background check.
- Site visit
- HCPF says site visits are required for all high-risk providers, including all non-emergent medical transportation providers, and that site visits are recorded. Federal rule (42 CFR 455.432, 455.450(b)-(c)): the state must do site visits before and after enrollment for providers in the 'moderate' or 'high' risk levels, and any enrolled provider must allow unannounced on-site inspections.
- Revalidation
- Health First Colorado and CHP+ providers must revalidate at least every five years. HCPF emails providers about six months before their deadline and posts a revalidation-dates spreadsheet; claims are denied for providers that miss the date. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.
- Provider manual
- Provider manual
Steps
- Choose the enrollment type (individual, individual within a group, group, facility, OPR-only, etc.)
- Apply in the Provider Web Portal and complete each panel (licenses, disclosures, EFT, attachments and fees)
- Upload a license copy, a W-9 signed within six months (if required for the enrollment type) and a voided check or bank letter for EFT
- Pay the application fee if institutional, and complete fingerprinting or a site visit if high risk
- After approval, contract and credential with the Regional Accountable Entity (behavioral health) and the MCOs you want to serve
Documents the state asks for
Joining managed-care plan networks
- Credentialing
- Health First Colorado's Accountable Care Collaborative uses four Regional Accountable Entities (RAEs), which run the capitated behavioral health benefit and provider networks, plus two physical health MCOs in certain areas. Every provider serving managed care members must first enroll with Health First Colorado. Behavioral health providers are contracted and credentialed directly by the RAEs. For ACC Phase III (from July 1, 2025), HCPF budgeted to centralize behavioral health credentialing so providers no longer credential separately with each RAE; its December 2025 oversight policy still refers to RAE credentialing. Centralized credentialing: planned for behavioral health under ACC Phase III; we could not confirm it has fully replaced RAE-by-RAE credentialing.
- Plans (state list)
- Rocky Mountain Health Plans (RMHP) — RAE Region 1
- RMHP PRIME (MCO)
- Northeast Health Partners — RAE Region 2
- Colorado Community Health Alliance — RAE Region 3
- Colorado Access — RAE Region 4
- Elevate (Denver Health) Medicaid Choice (MCO)
Frequently asked questions
How do I become a Medicaid provider in Colorado?
To bill Colorado Medicaid, enroll through Colorado interChange Provider Web Portal (Gainwell), run by Gainwell Technologies. The process has 5 steps, listed below with the documents the state asks for.
Is there an application fee to enroll in Colorado Medicaid?
HCPF lists the CY2026 fee as $750 for institutional providers, charged on new enrollments, revalidations and new locations. HCPF also has a process for paying a previously waived fee. Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.
How often must Colorado Medicaid providers revalidate?
Health First Colorado and CHP+ providers must revalidate at least every five years. HCPF emails providers about six months before their deadline and posts a revalidation-dates spreadsheet; claims are denied for providers that miss the date. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.