CO APCD Data Submission
The Colorado All Payer Claims Database (CO APCD) is the state’s most comprehensive source of health care claims information; representing the majority of covered lives in the state, including commercial health insurance plans, Medicare, and Health First Colorado (Colorado’s Medicaid program). With the exception of Medicare Fee-for-Service and ERISA-based self-insured employer plans, the CO APCD statute and rule require payers to submit claims data on a monthly basis. ERISA-based self-insured employers can voluntarily submit claims to the database, and CIVHC receives Medicare Fee-for-Service claims through the state agency request program.
Current Submitter Info
- CO APCD Health Insurance Submitters (May 2022)
- Claims Paid Through Dates (May 2023)
Submitter Resources
Payers submitting data to the CO APCD must adhere to the latest Data Submission Guide (DSG), which is updated annually through a collaborative payer rule change process with the Colorado Department of Health Care Policy and Financing (HCPF). Click here for more information on the annual DSG rule change process.
Payer Claims Data Submission Resources:
- Data Submission Guide v13
- Data Submission Guide v14
- New Data Elements Available (Fall 2021)
- New Data Elements Available (Fall 2022)
- 2023 CO APCD Rule
- HCPF CO APCD Rule Change Process
- CO APCD Enabling Legislation
Annual File Submissions:
On an annual basis beginning in 2019, payers are required to submit annual files related to drug rebates and Alternative Payment Models (APMs). Payers should populate the fields in the template files below for the Alternative Payment Model, APM Control Total, and Drug Rebate submissions, which include two new file types for the 2022 submission period: Value-Based Pharmacy Contract (VB) and Prescription Drug Affordability Board (PD) . Please remember to enter the relevant file name, payer code and performance period dates in the header and footer. In addition, please create a file name using proper naming conventions, as outlined in the Data Submission Guide. Links below will download the selected file in excel.
Alternative Payment Models (APMs)
- 2022 APM Data Submission Manual
- APM Blank File
- APM Control Total Blank File
- APM Blank File - DSG 13
- APM Control Total Blank File - DSG 13
- APM Contract (AC) Blank File - DSG 13
- APM Contract (AC) Scenario File - DSG 13
- APM Scenario File (AM) - DSG 13
- APM Control Total Scenario File - DSG 13
Drug Rebates (DR)
- 2022 Drug Rebate Data Submission Manual
- Drug Rebate Blank File
- 2022 PDAB Data Submission Manual
- 2022 Value-Based Pharmaceutical Contracting Data Submission Manual
- Drug Rebate Blank File - DSG 13
- PMB (PB) Blank File - DSG 13
- PDAB (PD) Blank File - DSG 13
- VBPC (VB) Blank File - DSG 13
- PBM (PB) Scenario File - DSG 13
- Drug Rebate Scenario File - DSG 13
- PDAB (PB) Scenario File - DSG 13
- VBPC (VB) Scenario File - DSG 13
Data Access and Privacy Information
If you are a submitter to the CO APCD and have questions, please email submissions@civhc.org