What services are covered under Health First Colorado’s ABA therapy benefits?

Health First Colorado covers ABA therapy sessions conducted by qualified providers, behavior management strategies, care coordination between various healthcare providers, and access to community support services to enhance social integration and overall well-being.

How can I verify if my specific Health First Colorado plan covers ABA therapy?

You can verify coverage by contacting Health First Colorado customer service or by logging into the Health First Colorado website or mobile app to review your insurance plan details and coverage options.

Is there a limit to the number of ABA therapy sessions covered?

Coverage limits, such as the number of therapy hours or sessions, can vary depending on the specific Health First Colorado plan. It’s essential to review your plan details or contact Health First Colorado to understand any restrictions.

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Health First Colorado ABA therapy in Colorado

ABA therapy, covered by Medicaid.

Health First Colorado covers ABA therapy for children under 21 with no dollar cap and no arbitrary hour limit. If your child qualifies, Blossom ABA handles everything between you and the first session.

Check my coverage

Call Us Any Time :

(877) 315-1069

ABA therapy in Colorado

ABA therapy, covered by Medicaid.

Check my coverage

Call Us Any Time :

(877) 315-1069

What we do with your Health First Colorado coverage

Confirm your RAE region and verify your benefits before you commit to anything
Submit prior authorization with full clinical documentation
Track reauthorization dates so your child's services never lapse
Appeal denials with clinical documentation that addresses the actual reason

What we do with your Health First Colorado coverage

Confirm your RAE region and verify your benefits before you commit to anything
Submit prior authorization with full clinical documentation
Track reauthorization dates so your child's services never lapse
Appeal denials with clinical documentation that addresses the actual reason

How we work with Health First Colorado

We manage Health First Colorado so you don't have to.

We verify first

Give us your Health First Colorado member ID and we'll confirm exactly what your child's coverage includes before you commit to anything. No mid-therapy surprises about what Medicaid will or won't pay for.

We submit the authorization

Health First Colorado requires prior authorization before ABA therapy begins. We know what documentation your RAE needs, how they want it formatted, and who to follow up with when they go quiet. You don't track any of it.

We explain your costs

For most Health First Colorado families, ABA therapy costs nothing out of pocket. Before your child's first session you'll know exactly where you stand based on your actual coverage.

We handle everything after

Claims, reauthorizations, appeals. If Health First Colorado denies something, we explain the real reason and appeal with documentation that addresses what they actually need.

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What Health First Colorado covers

Everything your child needs, authorized through EPSDT.

ABA therapy services available in Colorado

Four ways to bring Blossom into your family's life

Initial assessment

A comprehensive evaluation by a Board Certified Behavior Analyst who documents your child's current skills, identifies areas of need, and builds an individualized treatment plan. This is covered under Health First Colorado and is the required first step before therapy begins.

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Initial assessment

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In-Home ABA Therapy

One-on-one sessions with a trained Registered Behavior Technician in your home. Your child works on communication, behavior regulation, social skills, and daily living skills in the environment where those skills actually need to hold up.

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In-Home ABA Therapy

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BCBA supervision

Your BCBA oversees the treatment plan throughout, reviewing session data, updating goals, and adjusting the approach as your child makes progress. This is a covered service under Health First Colorado.

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BCBA supervision

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School-based and community ABA

Health First Colorado covers ABA in school settings and community environments. The setting is determined by what your child's treatment plan documents as most appropriate.

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School-based and community ABA

Health First Colorado covers ABA in school settings and community environments. The setting is determined by what your child's treatment plan documents as most appropriate.

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Parent Training

Direct instruction in the strategies your child's therapy team uses. Built into every Blossom ABA treatment plan and covered under Health First Colorado.

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Parent Training

Direct instruction in the strategies your child's therapy team uses. Built into every Blossom ABA treatment plan and covered under Health First Colorado.

Learn More

ABA therapy services available in Colorado

Call Us Any Time :

(877) 315-1069

Call Us Any Time :

(877) 315-1069

What makes Health First Colorado different from commercial insurance

No cap. No arbitrary limits. Coverage based on what your child actually needs.

Health First Colorado covers ABA therapy through the federal EPSDT benefit, which requires Colorado to cover all medically necessary services for children under 21. That's why there's no fixed dollar cap and no annual hour limit. Coverage is based on what your child's BCBA assessment shows they need, not a plan maximum.

Commercial plans in Colorado must cover ABA therapy under the state's autism insurance mandate, but they can set their own hour limits and cost-sharing requirements. EPSDT prohibits those restrictions for Medicaid-covered children. If your child has both Health First Colorado and a commercial plan, Medicaid coordinates as the secondary payer. Blossom ABA handles that coordination.

No cap. No arbitrary limits. Coverage based on what your child actually needs.

Does my child qualify?

Three things Medicaid looks at.

Age
Under 21. Coverage ends at the 21st birthday.

Diagnosis
A formal Autism Spectrum Disorder diagnosis from a licensed clinician is the standard pathway.

Medicaid enrollment
Your child must be enrolled in Health First Colorado. Income thresholds vary by household size. Families who exceed the standard income limit may still qualify through the Katie Beckett program, which evaluates the child's income independently. Apply through PEAK.

Age
Under 21. Coverage ends at the 21st birthday.

Diagnosis
A formal Autism Spectrum Disorder diagnosis from a licensed clinician is the standard pathway.

Age
Under 21. Coverage ends at the 21st birthday.

Diagnosis
A formal Autism Spectrum Disorder diagnosis from a licensed clinician is the standard pathway.

Find your RAE region

Your county determines your RAE. Your RAE handles authorization.

Colorado routes behavioral health authorization through four Regional Accountable Entities. Your RAE is assigned based on the county where your primary care provider is located. Your RAE does not change what your child is covered for. What differs is the authorization process, the contacts, and the timeline. Find your county below to go directly to your RAE's authorization details.

County

RAE

Adams

Colorado Access (Region 4)

Alamosa

Rocky Mountain Health Plans (Region 1)

Arapahoe

Colorado Access (Region 4)

Archuleta

Rocky Mountain Health Plans (Region 1)

Baca

Northeast Health Partners (Region 2)

Note: Denver members enrolled in Denver Health Medicaid Choice have a separate authorization structure. See how Denver Health works.

Before you call, during therapy, and if things go sideways.

Before you call us:

Have your Health First Colorado member ID ready
Have your child's autism diagnosis documentation accessible
Know the county your primary care provider is in

Before you call us:

During therapy:

We track your authorization period and submit renewal requests before the current one expires
We monitor your child's hours against the authorized amount
We keep you updated on coverage status throughout

During therapy:

Accurately record data on the child’s performance and behavior during therapy sessions.

Family Support:

We appeal with clinical documentation that addresses the RAE's actual concern
Most denials with clinical merit get overturned on appeal
You also have the right to request a State Fair Hearing through HCPF

Family Support:

Work collaboratively with family members to ensure consistent implementation of therapeutic strategies.

Katie Beckett, HCBS waivers, and Early Intervention.

Katie Beckett program
If your household income is too high for standard Medicaid, your child may still qualify through Katie Beckett, which assesses the child's income separately. Apply through PEAK.

Children's HCBS waivers and Community Centered Boards
Colorado's Home and Community Based Services waivers can add support on top of standard coverage, including respite care and family support services. Administered through Community Centered Boards. Blossom ABA can help connect your family to your local CCB.

Early Intervention Colorado
Children under three who show developmental delays are served through Early Intervention Colorado at no cost to families. Call 1-800-852-7157. ABA therapy coverage under Health First Colorado begins after the third birthday.