No autism diagnosis yet? You may not need one.
For Health First Colorado (Medicaid) members, an autism diagnosis is not required for behavioral therapy. A documented developmental or behavioral concern and a referral from your child's doctor can be enough to get started.
- For Health First Colorado members 20 and under
- Developmental delay and other concerns can qualify
- Under 3? Being at risk for delay can qualify
Prefer to talk now? Call (800) 513-8804
Three steps to your first session.
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1
We call you back
A BCBA calls you, usually within one business day, to hear about your child and answer your questions. No pressure, no cost.
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2
We check your coverage
We help you get a referral from your child's doctor, then submit the prior authorization to Health First Colorado for you.
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3
Assessment, then therapy starts
Your BCBA completes an assessment and writes a plan built around your child. Most Colorado families begin services within 2-4 weeks.
Behavioral therapy without the wait.
Many Colorado families wait months for an autism evaluation. If your child has Health First Colorado, you do not have to wait for that evaluation to ask about behavioral therapy. Health First Colorado covers Pediatric Behavioral Therapy, including ABA, for members 20 and under when it is medically necessary - and a qualifying condition can be developmental delay, intellectual disability, or another developmental or behavioral condition, not only autism.
For children under 3, being at risk for developmental delay can qualify. If your child already has an Early Intervention plan (IFSP) or other evaluations, share them with us - they help document your child's needs.
What is still needed: a referral or prescription from a doctor, physician assistant, nurse practitioner, or licensed psychologist who is enrolled with Health First Colorado; an assessment by our BCBA; and an approved prior authorization. Health First Colorado decides approval and the number of hours.
What to have ready
- Your child's Health First Colorado ID
- A note from your child's doctor about your concerns - we can help you ask
- Any Early Intervention plan (IFSP) or evaluations you already have
- A few words about what daily life looks like right now
Commercial plans work differently.
Commercial plans, including Anthem Blue Cross Blue Shield of Colorado and Aetna, generally require an autism diagnosis before they cover ABA. We check your benefits for free and can point you to Colorado diagnostic options while you wait.
If you have concerns about autism, a full evaluation is still valuable for your child's long-term care and school planning - whatever your insurance.
Start with what matters most to you.
Service
In-home ABA
A therapist comes to your home, three to five days a week, on your schedule.
How in-home ABA works →Service
Telehealth ABA
BCBA-led sessions by video, for families far from the Front Range or who want flexibility.
How telehealth ABA works →Insurance
Health First Colorado
Medicaid covers medically necessary ABA under 21, with no copay.
Medicaid ABA coverage →Insurance
Anthem BCBS
We are in-network with Anthem Blue Cross Blue Shield of Colorado.
Anthem ABA coverage →Insurance
Aetna
We are in-network with Aetna in Colorado.
Aetna ABA coverage →Location
Your city
Denver metro, Colorado Springs, Northern Colorado, and Boulder County.
See all Colorado cities →Colorado parents ask.
Does Health First Colorado require an autism diagnosis for ABA?
No. Health First Colorado covers Pediatric Behavioral Therapy, including ABA, for members 20 and under when it is medically necessary. A qualifying condition can be autism, developmental delay, intellectual disability, or another developmental or behavioral condition. Children under 3 can qualify if they are at risk for delay.
What do I need instead of a diagnosis?
A referral or prescription from your child's doctor, physician assistant, nurse practitioner, or a licensed psychologist enrolled with Health First Colorado, describing your child's needs. Our BCBA then completes an assessment and treatment plan, and we submit the prior authorization.
Is approval guaranteed?
No. Health First Colorado reviews every request and decides whether services are approved and how many hours. We help you put together a complete, accurate request.
Should we still get an autism evaluation?
If you have concerns about autism, yes - a full evaluation helps with long-term care and school planning. You just do not have to wait for it to ask about behavioral therapy through Health First Colorado.
Does this apply to Anthem or Aetna?
No. Commercial plans generally require an autism diagnosis before covering ABA. We check your benefits for free and can suggest diagnostic options.
Ready when you are
Tell us a little about your family and a BCBA will call you, usually within one business day. Prefer to talk now? Call (800) 513-8804, Mon-Sat 8am-7pm.
Ready to start ABA in Colorado?
Our intake team will verify your insurance, coordinate with your pediatrician, and assign a BCBA.