The Center for Improving Value in Health Care (CIVHC) recently released the Provider Payment Tool, the first health care transparency tool of its kind in Colorado. Through Senate Bill 22-068, the tool shows how payments made to providers vary across the state, with the intention of increasing health care payment transparency.

The Payment Provider Tool is the first comprehensive analysis identifying how much Colorado physicians and other providers get paid. It is a valuable tool for understanding health care costs in Colorado; the data the tool collects can provide insight into health care trends, payment patterns and costs. The CIVHC notes the tool as, “a way for increased transparency and equips payers and providers with information to benchmark their own payments, while helping consumers and employers understand reasonable costs.”


SB22-068 requires CIVHC, administrator of the Colorado All Payer Claims Database (CO APCD), to create a public report that displays payments made to Colorado health care providers for CPT (Current Procedural Terminology) codes and HCPCS (Healthcare Common Procedure Coding System) codes by county, Division of Insurance (DOI) region, and statewide. The report includes the following:

  • All current (effective in 2021) CPT codes and HCPCS with sufficient volume (statewide claim volume of 30 or more) for 2018, 2019, 2020 and 2021.
  • Payer breakouts for commercial, Medicaid, Medicare Advantage, and Medicare fee-for-service.
  • Total allowed amounts (payer and patient payments combined) at the 25th, 50th, 60th, and 75th percentile, and average total allowed amounts.
  • Anesthesiology payment calculations.

Learn more regarding Provider Payment Tool Methodology here.

Categories: Communications, ASAP