Balance Billing Laws in Colorado
Your medical billing rights and protections in Colorado.
Colorado enacted the Surprise Billing Protection Act (SB 20-199) in 2020, one of the most comprehensive state surprise billing laws in the nation. The law prohibits balance billing for emergency services and for non-emergency services at in-network facilities, and requires providers to hold patients harmless when disputes arise.
Key Protections in Colorado
Emergency services: Balance billing is prohibited for all emergency services; patients only pay their in-network cost-sharing
Out-of-network at in-network facility: Patients receiving non-emergency services at in-network facilities from out-of-network providers are protected from balance billing
Dispute resolution: Colorado has its own independent dispute resolution process separate from the federal IDR; median in-network rate is the benchmark
Transparency: Providers must give patients advance notice of their out-of-network status and estimated costs
Filing Information
Within 2 years of receiving the bill for state disputes
Additional Notes
Colorado's Surprise Billing Protection Act took effect January 1, 2021, ahead of the federal law. The state uses median in-network rates as the benchmark for dispute resolution. Colorado's law applies to fully insured plans; self-funded ERISA plans are governed by the federal NSA.
How to File a Complaint in Colorado
Gather Your Documentation
Collect your itemized medical bill, Explanation of Benefits (EOB) from your insurer, any prior authorization documents, and written communications with the provider or insurance company.
File with the State Regulator
Submit your complaint to the Colorado Division of Insurance. Include all supporting documents and a clear description of the billing dispute.
File complaint with Colorado Division of InsuranceFile with CMS if Federal Protections Apply
If your dispute involves the No Surprises Act (emergency care or out-of-network providers at in-network facilities), you can also file directly with the Centers for Medicare & Medicaid Services.
File with CMS No Surprises Help DeskRelated Articles
The No Surprises Act: What It Means for Your Medical Bills (2025 Update)
The No Surprises Act protects you from surprise out-of-network medical bills. Learn your rights, what's covered, what's not, and how to file a dispute.
Insurance Appeal Letter Template: How to Fight a Denied Claim
Use this insurance appeal letter template to fight a denied claim. Includes formal letter structure, medical necessity arguments, and escalation steps.
Medical Debt in America: What the Numbers Really Mean
An in-depth look at the medical debt crisis in America: $220 billion outstanding, 79 million affected, and actionable steps patients and attorneys can take.
Got a surprise medical bill?
Analyze with NilesAI