
Referrals
Some Cigna plans require a referral from your pediatrician or primary care provider, while others allow direct access to ABA therapy.
Diagnosis
Network status and benefits can differ based on your state or region, even within the same insurance company.
Prior Authorization
Most plans require prior authorization and documentation of medical necessity before therapy begins. We handle this process for you.
Session limits and costs
Coverage limits, copayments, coinsurance, and deductibles vary by plan. Some plans offer unlimited sessions; others have annual caps.


Health First Colorado Medicaid
- Health First Colorado (Medicaid)
- Colorado Medicaid
- Health First Colorado – Child & Family Coverage
- Health First Colorado – EPSDT (Well-Child / ABA)
- Health First Colorado Behavioral Health
- Health First Colorado Managed Care Plan
- Rocky Mountain Health Plans – Health First Colorado
- Colorado Access – Health First Colorado
- Kaiser Permanente – Health First Colorado
- UnitedHealthcare – Health First Colorado
- Child Health Plan Plus (CHP+)
- Colorado Child Health Plan (CHP)
- Medicaid Buy-In Program for Children with Disabilities
- Medicaid Buy-In Program for Working Adults with Disabilities
- Home and Community-Based Services (HCBS) Waiver
- HCBS Children’s Extensive Support (CES) Waiver
- HCBS Children’s Habilitation Residential Program (CHRP) Waiver
- HCBS Children’s Home and Community-Based Services (CHCBS) Waiver
- Colorado Youth Mental Health Treatment Act (CYMHTA)
- Health First Colorado Autism / ABA Services




In most cases (with some exceptions, such as Colorado Medicaid), insurance plans require a formal diagnosis of Autism Spectrum Disorder (ASD) from a qualified provider—such as a developmental pediatrician, neurologist, psychologist, or psychiatrist—before ABA therapy can be covered. Without this diagnosis, insurers typically do not consider ABA therapy medically necessary.
Almost always. Prior authorization means your insurance company must review and approve the treatment plan before services can start. Our team handles this process for you, submitting the necessary clinical documentation to ensure approval.
Yes. Insurance companies require documentation showing that ABA therapy is medically necessary for your child’s development. This is usually demonstrated through the diagnostic report and a treatment plan written by a BCBA outlining specific, measurable goals.
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Approval times vary by insurer, but typically range from 1–3 weeks after all documents are submitted. Delays can occur if additional information is requested. Our team stays in close contact with your insurance to help move the process along.
Yes, most plans include coverage for caregiver training as part of the ABA treatment program. These sessions are considered essential because progress is greatest when parents and caregivers are part of the learning process.
Many insurers do cover telehealth ABA sessions, especially for parent training or supervision by a BCBA. Coverage may depend on your state and specific plan. We can confirm eligibility during your benefits check.
If your plan excludes ABA or limits coverage, we’ll walk you through alternatives—such as appealing the denial, switching to a plan with autism benefits, or exploring private pay or grant options. Some states also offer Medicaid or autism mandates that ensure ABA coverage.




















