Colorado Medicaid RAEs: Behavioral Health vs. FFS

Updated October 9, 2026.

Colorado Medicaid behavioral health billing starts with the member’s Regional Accountable Entity (RAE) and the service benefit, not simply a Medicaid ID. Accountable Care Collaborative (ACC) Phase III began July 1, 2025 and reduced seven RAE regions to four. The region list below was cross-checked with official 2026 RAE materials as of October 9, 2026. HCPF July 2025 provider bulletin.

Use the official HCPF ACC Phase III map in the member communications toolkit (Figure 1) for geographic orientation. Verify the member’s actual assignment separately before choosing a claims route.

The four current RAE regions and plans

• Region 1: Rocky Mountain Health Plans (RMHP).

• Region 2: Northeast Health Partners (NHP).

• Region 3: Colorado Community Health Alliance (CCHA).

• Region 4: Colorado Access.

HCPF’s Phase III toolkit identifies the four entities. The 2026 RMHP manual, 2026 CCHA manual and Colorado Access transition page corroborate the current identities. Older seven-region lists describe Phase II.

Region 2 behavioral health is administered by RMHP

Northeast Health Partners remains the Region 2 RAE. Its 2026 RMHP manual says NHP delegated behavioral health and substance use contracting, credentialing, prior authorization and claims processing to RMHP beginning July 1, 2025. NHP continues primary care contracting and care coordination. Region 2 delegation, printed page 18.

That distinction changes whom a therapy practice contacts. Identify both the member’s RAE and the behavioral health administrator; do not send a general primary care contracting inquiry and assume it establishes behavioral health participation. The official NHP site is a starting point for Region 2 resources.

Behavioral health capitation versus fee-for-service

A RAE administers the capitated behavioral health benefit. Some services or circumstances instead belong to state fee-for-service (FFS). CCHA’s manual, for example, describes FFS situations involving no active RAE enrollment or a condition outside the RAE-covered benefit. Those conditions still require the applicable state coverage and billing rules. CCHA benefit and FFS guidance, page 40.

1. Verify Health First Colorado coverage and RAE assignment for the service date.

2. Check the service, diagnosis and benefit against the current state and administrator guidance.

3. Confirm the practice’s state enrollment and effective plan participation.

4. Resolve any authorization requirement and the correct claim submission route.

Use the eligibility verification guide for the coverage check. A county map helps orient a practice but does not replace a member-specific response. The 2026 RMHP manual directs providers to state interChange for eligibility and RAE/MCO enrollment verification.

The old first-six-visits FFS shortcut ended

Colorado Access says short-term behavioral health services previously billed as the first six FFS visits moved to the RAE starting July 1, 2025. Follow the covered-diagnosis and service requirements; do not use an old “six visits to the state first” instruction for current claims. Short-term behavioral health transition.

Enrollment, credentialing and active participation

Use the therapist enrollment guide for the state record and the PT 77 group guide for behavioral-health-only groups. Then ask the applicable administrator to confirm the network and effective participation for each billing entity, clinician and location.

The practical goal is a written answer to “who administers this member’s covered service, and are our records active for this date?” A familiar plan name or a working login cannot answer those questions by itself.

How Bomi can help

Bomi can help organize enrollment, payer follow-up and billing work. For help with a Colorado provider workflow, contact Bomi and describe the blocked task.

Related Colorado Medicaid guides

Behavioral health claims and telehealth. Find an existing provider ID or effective date.

Frequently Asked Questions

How many Colorado Medicaid RAE regions are there now?

ACC Phase III has four regions: RMHP in Region 1, Northeast Health Partners in Region 2, CCHA in Region 3 and Colorado Access in Region 4. The transition began July 1, 2025.

Who handles Northeast Health Partners behavioral health claims and credentialing?

NHP’s 2026 RMHP manual identifies RMHP as the delegated behavioral health and substance use administrator for these functions beginning July 1, 2025. Verify the member and current submission instructions.

Do I bill the first six short-term behavioral health visits to FFS?

The old first-six-visits FFS rule changed July 1, 2025. Colorado Access directs those services to the RAE, subject to covered-diagnosis and service requirements.