BEHAVIORAL HEALTH SERVICES PROVIDER IN COLORADO

Fatumata Kaba
Jul 6
3 min read

DELIVERING MENTAL HEALTH AND BEHAVIORAL SUPPORT TO PROMOTE STABILITY, WELL-BEING, AND COMMUNITY PARTICIPATION

Behavioral Health Services in Colorado support individuals with mental health needs, behavioral challenges, or co-occurring intellectual/developmental disabilities. These services are funded through Colorado Medicaid, the Behavioral Health Administration (BHA), and specific Home and Community-Based Services (HCBS) Waivers, such as the Children’s Extensive Support (CES) waiver, Supported Living Services (SLS) waiver, and Developmental Disabilities (DD) waiver.

1. GOVERNING AGENCIES

Agency: Colorado Department of Health Care Policy and Financing (HCPF)

Role: Oversees Medicaid funding for behavioral and mental health services through the state plan and HCBS waivers

Agency: Colorado Behavioral Health Administration (BHA)

Role: Regulates behavioral health providers and integrates services across systems

Agency: Colorado Department of Regulatory Agencies (DORA)

Role: Licenses behavioral health professionals (e.g., LPCs, BCBAs, LCSWs, Psychologists)

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Ensures federal compliance with HCBS behavioral services and Medicaid coverage

2. BEHAVIORAL HEALTH SERVICE OVERVIEW

Behavioral Health Services include assessment, intervention, monitoring, and support for individuals experiencing emotional, cognitive, or behavioral difficulties. Services are individualized and may include therapy, behavior plans, and family or caregiver training.

Approved providers may deliver:

Functional behavioral assessments (FBA)
Development and implementation of Behavior Support Plans (BSP)
Individual or group therapy (CBT, DBT, trauma-informed care, etc.)
Skills development and behavior stabilization
Caregiver coaching and staff training
Crisis de-escalation strategies and intervention planning
Documentation of behavior goals, outcomes, and data

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Colorado Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Enroll as a Medicaid behavioral health provider via the Gainwell Technologies Provider Portal
Be licensed or certified through DORA as one of the following:
- Licensed Professional Counselor (LPC)
- Licensed Clinical Social Worker (LCSW)
- Licensed Psychologist
- Board Certified Behavior Analyst (BCBA)
- Registered Psychotherapist (as applicable)
If offering services under a waiver, obtain HCBS waiver provider approval through HCPF
Carry liability and malpractice insurance
Maintain HIPAA-compliant documentation systems

4. PROVIDER ENROLLMENT PROCESS

Step 1: Acquire appropriate professional licensure or certification

Step 2: Enroll in Colorado Medicaid through the Gainwell Provider Portal

Step 3: If delivering waiver-based services, complete HCBS waiver enrollment with HCPF

Step 4: Network with Case Management Agencies (CMAs) and Regional Centers for referrals

5. REQUIRED DOCUMENTATION

Articles of Incorporation or proof of business registration
IRS EIN Letter
NPI confirmation
DORA licensure/certification
Medicaid provider ID
HCBS waiver enrollment approval (if applicable)
Policy & procedure manual including:
- Intake and consent forms
- Behavioral assessment and plan templates
- Progress notes and treatment documentation
- Confidentiality and HIPAA compliance policies
- Emergency and crisis protocols
- Client rights and complaint procedures
- Staff credentialing and CEU logs
- Incident reporting and audit readiness materials

6. STAFFING REQUIREMENTS

Role: Behavioral Health Clinician (LPC, LCSW, Psychologist, BCBA, etc.)Requirements:

Active license with DORA
Experience working with individuals with behavioral health or IDD needs
CPR certification and background check

Role: Behavioral Technician / Paraprofessional (if applicable)Requirements:

Supervised by licensed clinician
Background check, training in behavior management and de-escalation

Training Requirements for All Staff:

HIPAA and confidentiality
Positive behavior supports and person-centered planning
Crisis management and mandated reporting
Cultural competence and trauma-informed care
Annual CEUs and clinical supervision documentation

7. MEDICAID WAIVER SERVICES

Behavioral Health Services are reimbursed under:

Colorado Medicaid State Plan (standard outpatient behavioral health)
HCBS-CES (Children’s Extensive Support) Waiver
HCBS-SLS (Supported Living Services) Waiver
HCBS-DD (Developmental Disabilities) Waiver
Community Mental Health Supports (CMHS) Waiver

Approved providers may deliver:

Evidence-based therapies and behavioral interventions
Family and caregiver training and consultation
Crisis intervention planning
Documentation aligned with Individual Service Plans (ISPs) and waiver requirements

8. TIMELINE TO LAUNCH

Phase: Business Formation

Timeline: 1–2 weeks

Phase: Licensure and Credentialing

Timeline: 2–4 weeks (varies by profession)

Phase: Medicaid Enrollment via Gainwell

Timeline: 30–60 days

Phase: Waiver Enrollment and Referral Setup

Timeline: Ongoing

9. CONTACT INFORMATION

Colorado Department of Health Care Policy and Financing (HCPF)

Email: hcpf_hcbs_questions@state.co.us

Website: https://hcpf.colorado.gov

Colorado Behavioral Health Administration (BHA)

Website: https://bha.colorado.gov

Colorado Department of Regulatory Agencies (DORA) – Licensing

Website: https://dpo.colorado.gov

Colorado Medicaid Provider Enrollment (Gainwell Technologies)

Website: https://portal.co.gov

BEHAVIORAL HEALTH SERVICES PROVIDER IN COLORADO

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — COLORADO BEHAVIORAL HEALTH SERVICES PROVIDER

We support clinicians, therapists, and behavior specialists in launching Medicaid-compliant behavioral health practices across Colorado’s waiver and Medicaid systems.

Scope of Work: