Does Health First Colorado Cover ABA Therapy?
Yes. Health First Colorado covers ABA therapy for children and youth under 21 when it's medically necessary, and covered therapy costs your family nothing. Alpaca Health accepts Health First Colorado, checks your benefits for free, handles the approval paperwork with your BCBA, and doesn't have a waitlist.
How Health First Colorado covers ABA therapy
ABA falls under the Pediatric Behavioral Therapies benefit run by HCPF, the state's Medicaid agency.
- Where the rules live: HCPF sets who qualifies and which services it pays for in its billing manual.
- Part of EPSDT: The benefit falls under EPSDT, the federal rule that Medicaid pays for the care children need through age 20.
- No autism diagnosis needed: HCPF tells families that any eligible child can get this therapy when it's medically necessary (needed to treat their condition).
- Who approves it: Acentra Health reviews each request for HCPF, and your regional organization (the group that coordinates your child's care) doesn't approve it.
- CHP+ works differently: CHP+, the state's low-cost plan for families who earn too much for Health First Colorado, doesn't cover this benefit.
- Not sure which you have: We check whether your child has Health First Colorado or CHP+ during your free benefits review.
What Alpaca Health's data shows about ABA care with Health First Colorado
Every number below comes from the sessions, claims, and prior authorizations that partner clinics ran on Alpaca Health between August 2024 and August 2026 for Colorado families with Health First Colorado. It describes those families, not every Health First Colorado member.
Families who owed nothing
99.8%
Share of Colorado families with Health First Colorado whose settled claims carried no patient responsibility. Health First Colorado covers patient responsibility by plan design, so this reflects how the plan is written.
Alpaca Health partner-clinic caseload, Aug 2024 to Aug 2026. 446 families across 34 clinics.
On Health First Colorado
85.9%
Share of Colorado families at partner clinics whose primary payer is Colorado Medicaid.
Alpaca Health partner-clinic caseload, Aug 2024 to Aug 2026. 531 families across 37 clinics.
Median days to a payer decision
19.3
Days from the moment a partner clinic submits a prior authorization to the moment Health First Colorado approves or denies it. More than half of decisions took longer than 14 days. Middle half of requests: 12 to 27 days.
Alpaca Health partner-clinic caseload, Aug 2024 to Aug 2026. 531 families across 37 clinics.
How Health First Colorado prior authorizations ended
- Approved78.2%
- Withdrawn before a decision15.3%
- Still awaiting a decision4.2%
Share of prior authorization requests by outcome. Outcome groups with too few families behind them are not shown, so these shares do not add to 100. 431 families across 36 clinics.
Where therapy hours were delivered
- At home55.3%
- In a clinic office20%
- At school9.4%
- By telehealth9.2%
- Other settings6%
Share of delivered therapy hours by the place of service billed on each signed session note. Alpaca Health partner-clinic caseload, Aug 2024 to Aug 2026.
Families who had at least one telehealth session
84%
Telehealth is a small share of total hours, and most Colorado families with Health First Colorado used it at least once.
Alpaca Health partner-clinic caseload, Aug 2024 to Aug 2026. 446 families across 36 clinics.
These figures describe clients of Alpaca Health partner ABA clinics whose primary insurance was Health First Colorado. They are not measurements of every Health First Colorado member, and they are not meant for comparing insurers. A figure appears only when at least 25 families from at least 3 clinics sit behind it.
Start ABA therapy nowWhat your child needs to qualify
1. Health First Colorado before age 21
Your child must be enrolled in Health First Colorado and be 20 or younger. The benefit ends at age 21.
2. A qualifying condition
Autism counts, and so do other conditions that affect how a child develops or behaves, such as a delay in reaching milestones. Children under 3 can also qualify if they're at risk for delay.
3. An evaluation and a written order
An evaluation has to recommend this therapy for your child. A doctor, nurse practitioner, physician assistant, or licensed psychologist must also sign a written order.
4. Needs that affect daily life
Your child's behavior or skill gaps must get in the way of daily life, learning, or safety. The assessment must also show that therapy can help in ways you can measure, such as building new skills or joining in more activities.
5. A treatment plan from an enrolled provider
The BCBA tests your child's skills with a standard tool and writes a treatment plan with goals you can measure. The BCBA and their practice must both be enrolled with Health First Colorado.
How prior authorization works with Health First Colorado
This step means getting approval from the state before therapy starts. Your child's provider sends the request to Acentra Health, which reviews these requests for HCPF.
- What goes in: The written order, the assessment, and a treatment plan with the hours requested go through ColoradoPAR, the state's approval program.
- Who decides: Licensed clinical reviewers at Acentra Health make the call, and you and your provider both get the decision letter.
- Six months at a time: Each approval lasts up to six months, and every reauthorization (a renewed approval) needs a new request.
- Before a denial: Reviewers call the doctor who sent the request to talk it through, which HCPF calls a peer-to-peer review.
- If you disagree: Your provider can ask for a second review, and you can appeal to a judge, with a deadline that counts from the date on your denial letter.
- Step 1Evaluation and orderAn evaluation recommends therapy, and a licensed clinician orders it in writing.
- Step 2AssessmentThe BCBA measures your child's skills with a standardized assessment.
- Step 3Treatment planThe BCBA sets measurable goals and the weekly hours to request.
- Step 4ApprovalAcentra Health reviews the request for Health First Colorado and approves up to six months.
- Step 5Therapy and renewalsTherapy begins, and your provider asks Health First Colorado again for each added six months.
What Health First Colorado covers for ABA therapy
Your child's provider asks for hours under each billing code (CPT code) below. You get a letter showing what was approved. Parent training has its own code (97156), but it isn't on HCPF's list.
- Assessment (97151): The BCBA's skills assessment and treatment plan, billed once a year.
- One-to-one therapy (97153): A certified behavior technician, such as a Registered Behavior Technician (RBT), works with your child using the BCBA's plan.
- BCBA sessions (97155): The BCBA works one-on-one with your child to adjust the plan.
- Group sessions (97154, 97158): Therapy in a group with other children when the treatment plan calls for it.
There's no fixed weekly limit on hours, because EPSDT rules bar arbitrary caps on children's care. Reviewers set your child's weekly ABA hours from the treatment plan. But if your child has access to school, an HCPF policy memo says 40 hours of clinic therapy won't be covered. That changes only if the district shows it can't serve your child in a classroom.
What families pay with Health First Colorado
Covered ABA costs your family nothing. The member handbook says members 20 and younger get behavioral therapies with no cost or co-pay.
- Families who owed nothing: 99.8% of families with Health First Colorado at Alpaca Health partner clinics owed nothing once claims were processed from August 2024 to August 2026.
- Payment in full: Providers must accept Health First Colorado's payment as payment in full, and they can't bill you for services denied over missing paperwork.
- Other insurance: If your child also has private insurance and the provider takes both, you pay only Health First Colorado co-pays, and this therapy has none.
- Buy-In premiums: Children who join through the Children's Buy-In may owe a monthly premium based on family income, but they have no co-pays.
- Services not covered: A provider can bill you only for services Health First Colorado doesn't cover, and only under a written agreement.
Where Alpaca Health accepts Health First Colorado
Pick Colorado or your city below to see local BCBAs, in-home options, and the Colorado rules that shape your coverage.
How Alpaca Health handles your Health First Colorado benefits
You don't have to call Health First Colorado yourself. After you fill out our short intake form, our team checks your child's coverage. We follow up within one business day with what's covered and what comes next.
- Coverage check: We confirm your child's Health First Colorado is active before therapy starts.
- Approval paperwork: Your BCBA writes the assessment and treatment plan Acentra Health reviews, and we handle the submission.
- A BCBA who takes your plan: We match you with an independent BCBA who accepts Health First Colorado and has openings now.
Health First Colorado BCBAs near you
Each clinician below accepts Health First Colorado and works with Alpaca Health. Browse the full provider directory, or fill out the intake form and we'll match you.
Amari Major is a Board Certified Behavior Analyst with over five years of experience in ABA therapy, clinical program development, and team supervision across home, school, clinic, and telehealth settings.
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Amber Moore, M.S., BCBA, is a Board Certified Behavior Analyst and the co-founder and clinical director of Love Forward ABA. She brings more than ten years of experience supporting children and families, blending play with learning in individualized, neuro-affirming ABA care.
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Ashlee Ramirez is a Board Certified Behavior Analyst with nine years of experience working with individuals with developmental and intellectual disabilities, especially the autism community, across a wide range of ages.
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Brian Peña, M.Ed., BCBA, LBA, is a Board Certified Behavior Analyst and the co-founder and clinical director of Love Forward ABA. He focuses on early intervention for children ages 2 to 8, speaks Spanish, and is passionate about supporting Spanish-speaking and first-generation families.
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Christina Williams is the founder of Little Moments Behavioral Health and an autistic Board Certified Behavior Analyst who has worked in ABA since 2016. She works collaboratively with each family to create meaningful change tailored to their needs, because no two families are the same.
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Christine Coffman, M.Ed., BCBA, is the founder of Training Wheels, a clinician-owned and clinician-operated ABA practice in Colorado. She built it around ethical practice, realistic caseloads, and genuine support for the clinicians and RBTs doing the work.
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Daniel Guglielmo is a Licensed and Board Certified Behavior Analyst and behavioral health executive with extensive experience building, leading, and overseeing high-quality Applied Behavior Analysis services in regulated healthcare environments.
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Elyanna Myer is a Board Certified Behavior Analyst and the founder of Sunrise Behavioral Consultants. She has extensive experience working with clients aged 18 months to 21 years across diverse settings, including in-home, school, clinic, telehealth, and youth centers.
Book a consultationView profileDoes my child need an autism diagnosis for ABA with Health First Colorado?
No, HCPF doesn't require an autism diagnosis for this therapy. A child with a developmental delay or another condition that affects behavior can also qualify. An evaluation still has to recommend therapy, and a clinician has to order it.
Can my child get ABA if we earn too much for Health First Colorado?
Possibly, through the Children's Buy-In. It's for children under 19 with a qualifying disability whose families earn too much for Medicaid or CHP+. Children in the Buy-In get the same benefits as other members, so ABA is open to them too. You don't have to apply for Social Security disability first.
Does my child need a waiver to get ABA in Colorado?
No, ABA comes through EPSDT, so any eligible child can get it without a Medicaid waiver. Children on a waiver can still get ABA. Waivers add other help that EPSDT doesn't cover, such as respite care (short breaks for caregivers) and changes to your home.
Does Health First Colorado cover autism testing?
Yes. Members 20 and younger get evaluations of their development and behavior with no cost or co-pay. If your child doesn't have a diagnosis yet, Alpaca Health offers an autism evaluation and checks your coverage first.
Can my child get ABA at home, at school, or by telehealth with Health First Colorado?
Yes, the state pays for in-home ABA sessions, plus therapy in an office, in the community, at school, or by telehealth. School sessions must follow your school district's rules. Therapy the school provides under your child's IEP (special education plan) is paid by the district instead.
Check your Health First Colorado coverage
Tell us about your child and their Medicaid coverage. We'll confirm your Health First Colorado benefits, handle the approval paperwork, and match you with a BCBA who takes your plan.