Surprise bills and ambulance bills in Colorado

For emergency care and for non-emergency care at an in-network facility, an out-of-network provider must bill your insurer and may charge you only your in-network copay, coinsurance and deductible.

Checked against official sources: October 30, 2026.

What Colorado adds

State law

Colorado out-of-network billing law

Law: HB 19-1174, HB 22-1284; C.R.S. 10-16-704(3), (5.5); C.R.S. 12-30-112, 12-30-113

Which plans it covers

Health insurance plans regulated by the Colorado Division of Insurance. Self-funded employer plans are generally covered only by federal law.

What it adds

For emergency care and for non-emergency care at an in-network facility, an out-of-network provider must bill your insurer and may charge you only your in-network copay, coinsurance and deductible. If you paid more than you owed, the provider must refund it within 60 days of being told, or pay 10% interest. An out-of-network provider must give you a written cost estimate within 3 business days if you ask.

Ground ambulance

The state protects you

If you have a state-regulated plan and a private ambulance company that has no contract with your plan takes you by emergency ambulance, you owe only your in-network deductible, coinsurance or copay; the plan pays the company a set rate. This rule does not apply to ambulances run by a fire department or other government agency. No state rule limits ground ambulance bills for uninsured patients.

Law: C.R.S. 10-16-704(5.5)(d); C.R.S. 3 CCR 702-4, Regulation 4-2-66

Law: C.R.S. 10-16-704(3), (5.5); C.R.S. 12-30-112, 12-30-113

Itemized bills and price estimates in Colorado

Colorado law gives you a right to an itemized bill.

If you ask in writing, a debt collector collecting a medical debt must stop collecting until it sends you a free itemized statement: the provider's name and address, dates of service, each service or item, the original amount, interest, fees, payments, insurance and discounts, and for hospital debt whether you were screened and found eligible for financial assistance. Before a hospital bill goes to collections, the hospital and professionals must give you a plain-language explanation of the services and fees. A provider that charges a facility fee must give you a standardized itemized bill.

Law: C.R.S. 5-16-109(5), 25.5-3-506(1)(c), 6-20-102(3)(a)(II)

Price estimates

If you plan to pay for care yourself, a provider or facility must give you a written estimate of the total cost before the service if you ask, itemized by component, in English or Spanish. The final bill may be no more than 15% or $400 above the estimate, whichever is less, unless an emergency or unforeseen necessary care happens. Hospitals must also tell you of your right to an estimate of the average charge for a common inpatient procedure before admission, and must post their Medicare rates. A hospital that was not in material compliance with federal price transparency rules on the date of your care may not send that bill to collections, sue you or report it to a credit bureau.

Law: C.R.S. 25-49-106, 6-20-101, 25.5-1-903, 25.5-1-904

Where to complain in Colorado

Free tools, letters and checklist

Questions about medical bills in Colorado

Am I protected from ground ambulance bills in Colorado?

If you have a state-regulated plan and a private ambulance company that has no contract with your plan takes you by emergency ambulance, you owe only your in-network deductible, coinsurance or copay; the plan pays the company a set rate. This rule does not apply to ambulances run by a fire department or other government agency.

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