Anthem Blue Cross and Blue Shield Behavioral Health Reimbursement Rates in Colorado (2026)

Anthem organizes its Colorado behavioral health rate files by employer EIN for group plans and by HIOS number for individual plans, not by a single statewide list a practice can search. That means the “Anthem rate” for a given CPT code isn’t one number, it’s whatever the aggregation across many separate employer and individual filings happens to average out to.

A quick note on methodology: the figures below come from Fuse’s own extraction of Anthem’s August 2026 Colorado machine readable files. We pulled every dollar-denominated fee schedule rate attached to these CPT codes in the statewide network file (excluding percentage-of-charges entries), matched each listed NPI against the federal NPPES registry, kept only individual behavioral health clinicians (psychiatrists, psychologists, therapists, counselors and psychiatric nurse practitioners) whose registered practice location is in Colorado, and computed the statistics across distinct provider-rate pairs. Practices running care-management programs can find the same analysis for Anthem’s RPM, CCM and RTM rates in Colorado.

Anthem’s Negotiated Rates for Behavioral Health CPT Codes

Anthem Blue Cross and Blue Shield publishes negotiated rates for behavioral health services through its Colorado Machine Readable Files. The table below reflects August 2026 data for three commonly billed codes.

Rates extracted from Anthem’s August 2026 Colorado machine readable files.

Anthem’s files update monthly, so this table is labeled with its extraction date and should not be treated as a fixed, permanent figure.

Why One Anthem Number Represents Many Separate Filings

A statewide mean or median from Anthem’s Colorado files pools an enormous number of distinct negotiated arrangements. Anthem organizes its files by employer EIN or HIOS number, so the aggregation choices behind any published statistic materially shape the result. Two practices billing the identical CPT code to Anthem in Colorado can see meaningfully different reimbursement depending on the specific plan, the employer group behind it and the provider’s credential or setting.

Anthem also notes that its files represent an as-of-date snapshot subject to change before the next monthly update. That means a rate pulled today is directional information about where Anthem’s Colorado network tends to land, not a number a practice can treat as fixed. A statewide average can provide a directional market benchmark, but it cannot predict payment for a particular plan, provider or visit.

What Self-Pay Behavioral Health Care Costs in Colorado

Cash rates for behavioral health services in Colorado vary practice by practice, and they are not simply the inverse of insurance negotiated rates. WellPower, Denver’s community mental health center, published a fiscal-year 2025 self-pay schedule listing $225 for a psychiatric diagnostic evaluation (CPT 90791) and $205 for a 60-minute psychotherapy session (CPT 90837). At the lower end, Bridgeways Integrative Psychotherapy, a telehealth practice serving Colorado clients, publishes a Good Faith Estimate fee sheet listing $160 for an initial intake under CPT 90791 and $140 for a 53-to-60-minute session under CPT 90837. The spread between those two published schedules is itself the lesson: a single “Colorado cash rate” no more exists than a single Anthem rate does.

Published cash pricing specific to CPT 96130 is harder to find. Psychological testing is often billed as part of a bundled assessment package rather than priced as a standalone code, so a practice’s public rate sheet may not separate it out the way it does for an evaluation or a therapy session.

What Colorado’s Surprise-Billing Law Does and Doesn’t Cover

House Bill 19-1174, Colorado’s out-of-network law in effect since January 2020, protects patients from balance billing for emergency care and for out-of-network providers seen at in-network facilities, and it sets the reimbursement formulas carriers use in those situations. It does not create a self-pay pricing disclosure requirement for behavioral health practices; the relevant obligation for uninsured or self-pay patients comes from the federal No Surprises Act, with which Colorado aligned its own rules in 2022.

Under the federal Good Faith Estimate requirement, providers generally must give patients a written estimate, triggered when an uninsured or self-pay patient requests one or schedules care at least three business days in advance. If the actual bill exceeds that estimate by $400 or more, the patient can pursue the federal patient-provider dispute resolution process.

What This Means for Your Practice

Anthem rate tables pool many distinct EIN- and HIOS-organized plans into one statewide figure, which is exactly the kind of aggregation that makes a published average unreliable for a single patient.

The practical response is to verify current eligibility and plan-specific benefits for the scheduled CPT code before the visit, rather than reading a pooled statewide average as a patient-specific payment estimate.

The same logic applies on the payment side. A statewide average cannot tell you whether Anthem is actually paying your practice what your contract says it should. That requires checking reimbursements against your own contracted rates, claim by claim. Fuse helps practices do exactly this: it verifies reimbursements against past claims data and places automated phone calls to payers to confirm insurance coverage, so discrepancies between what a contract promises and what actually gets paid surface before they quietly accumulate into lost revenue.

Verify Anthem Benefits Before the Visit

A statewide average is a starting point for budgeting and negotiation conversations, not a substitute for confirming what a specific patient’s plan will actually pay. Fuse verifies current eligibility and plan-specific benefits at the CPT code level before the visit, combining past claims data with automated phone calls to payers, helping practices estimate expected copay, coinsurance and deductible responsibility for the scheduled procedure and get paid what they are contractually owed. See how CPT-level verification works for behavioral health practices.

Disclaimer: This article uses rate information from the Machine Readable Files that Anthem Blue Cross and Blue Shield publishes under the federal Transparency in Coverage rule. These files are posted to satisfy the regulation, not to be read: the file behind this analysis unpacks to 3 gigabytes of raw pricing data, millions of negotiated rates that no spreadsheet can open. Fuse built its own pipeline to extract and verify the figures above. This analysis focuses on a single payer and will not reflect rates from all available insurance options in Colorado. Fuse makes every effort to provide accurate and current information, but healthcare pricing can change frequently, and individual circumstances may affect actual costs. This information does not guarantee specific pricing. Practices should verify current rates directly with Anthem before relying on them for billing or negotiation decisions.