Starting ABA therapy for your child involves more steps than most families expect — and the gap between "I think something is different about my child" and "my child's first therapy session" is longer and more confusing than it needs to be. This guide walks every step of that path: what to watch for, how to get a diagnosis, what insurance covers, how the evaluation works, and what happens once therapy begins.
Step 1: Noticing the signs
Most families start here. Something feels different — your toddler isn't meeting language milestones, or they're meeting them and then losing them. They're not responding to their name reliably. They're intensely focused on specific objects or routines in ways that seem beyond typical preference. They're struggling with social interaction in ways their peers don't seem to.
These observations are the beginning of the process, not the diagnosis. The next step is a conversation with your child's pediatrician. Describe specifically what you're seeing — concrete examples are more useful than general descriptions. Ask for a developmental screening if one hasn't been done, and ask for a referral to a developmental pediatrician or psychologist if the screening raises concerns.
Early identification matters clinically. Research consistently shows that earlier access to ABA and early intervention is associated with stronger outcomes in communication, social skills, and adaptive behaviour. The average age of autism diagnosis nationally is still around 47 months — but diagnosis is reliably possible as early as 18–24 months in many children. Acting on early concerns rather than waiting is consistently the right call.
Step 2: Getting a diagnosis
Before ABA therapy can begin, your child needs a confirmed autism spectrum disorder diagnosis from a qualified clinician. Insurance requires this before authorizing ABA services — it is the gate that opens access to everything that follows.
The diagnostic evaluation is typically conducted by a licensed psychologist, neuropsychologist, or developmental pediatrician. It involves a detailed parent interview, standardized assessment tools including the ADOS-2, and direct observation of your child. The evaluation takes 3 to 5 hours across one or two appointments. You'll receive a written report with the diagnosis and recommendations, typically within 1 to 3 weeks.
Blossom offers autism assessment and diagnosis services in Georgia, Tennessee, Virginia, and Maryland — with results typically available within 30 days. If your child already has a diagnosis, you can move directly to step 3.
Step 3: Sorting out insurance
This is the step most families dread and most guides skip. It doesn't need to be complicated if you know what to ask.
The short version: most private insurance plans cover ABA therapy, and Medicaid covers it for eligible children in all five states Blossom serves. The federal Mental Health Parity and Addiction Equity Act requires that plans covering ASD treatment do so on equal terms with other medical benefits. All five of Blossom's states — Georgia, Tennessee, Virginia, North Carolina, and Maryland — have state insurance mandates requiring coverage of autism treatment including ABA.
What you need to confirm before starting:
Is your plan fully insured or self-funded? Self-funded employer plans are governed by federal ERISA law rather than state mandates — they may still cover ABA, but it's not legally required. Check your Summary Plan Description or ask HR directly.
Does your plan specifically cover ABA? Ask your insurer about CPT codes 97153 (direct therapy) and 97155 (BCBA protocol modification). Confirm your deductible, copay or coinsurance, out-of-pocket maximum, and any annual dollar limits.
Is prior authorisation required? Almost always yes. Prior auth must be obtained before services begin. Blossom handles this directly for all enrolled families.
For Medicaid families: Georgia Medicaid (Georgia Families, PeachCare for Kids, CareSource), TennCare, Virginia Medicaid (DMAS) and FAMIS, NC Medicaid and Health Choice, and Maryland Medicaid all cover ABA therapy with typically no out-of-pocket cost to families.
For Georgia families who don't qualify based on household income: the Katie Beckett Waiver extends Medicaid eligibility based on your child's disability rather than family income. It's one of the most underused resources in Georgia.
For a full breakdown of what insurance covers in each state, annual caps, age limits, and how to verify your benefits, see our guide: Does Insurance Cover ABA Therapy? A State-by-State Guide for GA, TN, VA, NC & MD
For a breakdown of what ABA therapy actually costs and what families typically pay after insurance, see: How Much Does ABA Therapy Cost? A 2026 Pricing Guide
Blossom verifies your insurance within 24 hours and handles prior authorisation directly — you don't manage any of that paperwork.
Step 4: Choosing a provider
Once you know your insurance situation, you're choosing a provider. These are the questions that actually distinguish quality ABA from adequate-on-paper ABA:
Is a credentialed BCBA actively supervising your child's programme? The BCBA is the clinician who designs your child's treatment plan and makes all clinical decisions. They should observe sessions regularly and be in consistent contact with your family — not just appear on paperwork. In Virginia, BCBAs must also hold a state-issued Licensed Behavior Analyst credential in addition to the national BACB certification.
Where does therapy happen? In-home ABA therapy means your child learns in the environment where they actually live. Skills generalise more reliably when they're taught in the context of real daily routines. Blossom also offers center-based ABA at clinic locations in Georgia.
Is parent training built in? Parent training isn't optional in quality ABA — it's how skills carry over between sessions. Blossom includes parent training in every treatment plan.
How quickly can you start? Waitlists are a real issue across ABA providers. Blossom has no waitlist in its service states and can typically begin services within 2 to 4 weeks of confirmed insurance authorisation.
What does the programme look like over time? Treatment plans should evolve as your child grows and masters goals. A plan that looks identical six months later isn't being actively managed.
For more on what to look for in an ABA therapist and how credentials work in each state, see our guides: ABA Therapists in Georgia | ABA Therapists in Tennessee | ABA Therapists in Virginia | ABA Therapists in North Carolina | ABA Therapists in Maryland
Step 5: The ABA assessment
Once you've confirmed your provider and insurance, the next step is the ABA assessment — conducted by Blossom's BCBA before therapy begins.
The assessment typically takes 2 to 4 hours across one to two visits and happens in your home. The BCBA conducts a detailed parent interview, observes your child in naturalistic play, and uses standardized tools to assess current skill levels across communication, social skills, play, daily living skills, and adaptive behaviour. If your child has specific challenging behaviours, the BCBA will gather the information needed to understand what's driving them.
From the assessment, the BCBA writes your child's individualized treatment plan — specific, measurable therapy goals, the strategies to achieve them, how progress will be tracked, and the recommended weekly therapy hours. That plan is submitted to insurance for prior authorisation.
For a full step-by-step walkthrough of what the ABA assessment involves and what happens after, see: What Happens at an ABA Therapy Evaluation? A Step-by-Step Guide for Parents
Step 6: Prior authorisation and timeline
After the treatment plan is written, it goes to your insurer for prior authorisation. Blossom submits this directly on your family's behalf. Typical turnaround is 7 to 14 business days.
Here is the realistic timeline from first contact to first session:
Step | Typical timing |
Contact Blossom | Day 0 |
Insurance verified | Within 24 hours |
Autism diagnostic evaluation (if needed) | 1–2 weeks from scheduling |
Diagnosis report received | 1–3 weeks after evaluation |
ABA assessment with BCBA | Within 1–2 weeks of confirmed diagnosis |
Treatment plan written | Within 1 week of assessment |
Prior authorisation submitted | Same week as treatment plan |
Prior authorisation approved | 7–14 business days |
First therapy session | Same week as authorisation |
For families who already have an autism diagnosis, the total timeline from first contact to first session is typically 3 to 4 weeks.
Step 7: The first session — and what therapy actually looks like
The first session is not what most families expect. It is not drills, flashcards, or demands. It is play.
The RBT assigned to your child spends the first sessions building rapport — joining in with whatever your child is interested in, keeping the mood low-pressure, and beginning to learn what motivates your child. This process, called pairing, is the foundation of effective ABA. Without it, no instruction sticks.
Over the following weeks, the RBT works on the goals in the treatment plan — teaching communication skills, social skills, play skills, daily living skills, and the reduction of any challenging behaviours — using positive reinforcement and a structured but flexible approach matched to your child's learning style.
The BCBA observes sessions regularly, reviews data, meets with your family, and updates the treatment plan as your child progresses. Parent training sessions — built into the plan at Blossom — teach you the same strategies the RBT uses so that skills transfer into daily family life between appointments.
Most children receive ABA therapy multiple times per week. Session frequency and hours are determined by the BCBA's clinical recommendation based on your child's assessed needs — not by a standard schedule.
Blossom ABA: where we serve
Blossom ABA provides in-home ABA therapy, center-based ABA, autism assessment and diagnosis, school-based ABA, and parent training across five states — no waitlist, most insurances accepted.
Georgia — in-home statewide plus center-based clinics in Riverdale and Peachtree Corners. Georgia Medicaid, PeachCare, and CareSource accepted.
Tennessee — in-home statewide across Middle, East, and West Tennessee. TennCare accepted.
Virginia — in-home and daycare-based ABA across Northern Virginia and Hampton Roads. Virginia Medicaid (DMAS) and FAMIS accepted.
North Carolina — in-home statewide from Charlotte to the coast. NC Medicaid, Health Choice, and NC Tailored Plans accepted.
Maryland — in-home statewide. Maryland Medicaid accepted.
Ready to take the next step? Contact our team or call 877-315-1069. We'll verify your insurance within 24 hours, handle prior authorisation, and help you understand exactly what your child's ABA programme will look like before committing to anything.
Frequently asked questions
How do I start ABA therapy for my child?
The path to ABA therapy has six stages: noticing developmental differences and speaking with your pediatrician; getting a formal autism diagnosis from a licensed clinician; verifying insurance coverage and confirming benefits; choosing a credentialed provider; completing the BCBA-conducted ABA assessment; and obtaining prior authorisation before the first session. Blossom handles insurance verification and prior authorisation directly — the administrative burden doesn't fall on your family.
Does my child need an autism diagnosis to start ABA therapy?
Yes. A confirmed autism spectrum disorder diagnosis from a licensed psychologist, neuropsychologist, or developmental pediatrician is required before insurance will authorise ABA therapy. If your child doesn't yet have a diagnosis, that step comes first. Blossom offers autism assessment and diagnosis services in Georgia, Tennessee, Virginia, and Maryland.
Does insurance cover ABA therapy?
Yes — all five states Blossom serves have insurance mandates requiring coverage of ABA therapy. Georgia, Virginia, North Carolina, and Maryland have private insurance mandates. Tennessee coverage is available through most major insurers under federal parity rules. Medicaid covers ABA therapy in all five states for eligible children with typically no out-of-pocket cost to families. For a full breakdown by state, see our ABA therapy insurance guide.
How much does ABA therapy cost?
Without insurance, ABA therapy typically costs $120 to $250 per hour for direct therapy. With insurance, most families pay only their deductible and copays. With Medicaid, most families pay nothing. Out-of-pocket maximums — typically $8,000 to $15,000 for most plans — mean that many families with intensive programmes effectively pay nothing once the maximum is reached for the year. For the full breakdown, see our ABA therapy cost guide.
How long does it take to start ABA therapy after a diagnosis?
For families who already have an autism diagnosis, the typical timeline from first contact with Blossom to first therapy session is 3 to 4 weeks. This includes insurance verification, the ABA assessment, treatment plan writing, and prior authorisation. Blossom handles all of that directly.
What happens at the ABA assessment?
The ABA assessment is conducted by a Blossom BCBA — typically in your home — and takes 2 to 4 hours across one to two visits. It includes a detailed parent interview, direct observation and play-based skill assessment with your child, and documentation of any challenging behaviours. The result is your child's individualized treatment plan. For a full walkthrough, see our ABA evaluation guide.
What does ABA therapy look like day to day?
Your child's RBT delivers sessions multiple times per week in your home, school, or daycare. Sessions are play-based and goal-directed — working on communication, social skills, daily living skills, and the reduction of challenging behaviours through positive reinforcement. The BCBA observes regularly, reviews session data, and updates goals as your child progresses. Parent training — built into every Blossom programme — teaches you the same strategies so progress continues between sessions.
What if my child doesn't qualify for Medicaid based on household income?
For Georgia families, the Katie Beckett Waiver extends Medicaid eligibility to children based on their disability rather than family income. For families in other states, Blossom can help identify the most appropriate coverage pathway. Contact our enrollment team to discuss your specific situation.
Is ABA therapy available at home?
Yes. Blossom's primary service model is in-home ABA therapy — therapy delivered in the environment where your child actually lives. Skills generalise more reliably when they're learned in real daily routines rather than transferred from a clinic. Blossom also offers center-based ABA in Georgia and school-based ABA across all five states.
Sources
Autism Speaks. Applied Behavior Analysis. https://www.autismspeaks.org/applied-behavior-analysis
Behavior Analyst Certification Board. BCBA credential. https://www.bacb.com/bcba/
CDC. Autism spectrum disorder: Treatment. https://www.cdc.gov/autism/treatment/index.html
Shaw KA, et al. Prevalence and Early Identification of ASD — ADDM Network, 2022. MMWR 2025;74(No. SS-2):1–22. https://www.cdc.gov/mmwr/volumes/74/ss/ss7402a1.htm
