If your child has Health First Colorado, the state’s Medicaid program, ABA therapy is a covered benefit. Coverage depends on two things: your child’s age and whether the therapy is medically necessary. This guide walks through who qualifies, what your provider has to send the state, how long approval lasts and what to do if the answer is no.
Right now, 51 providers in our directory say they accept Health First Colorado. You can browse every Medicaid ABA provider in Colorado or narrow it to in-home or center-based care.
Who is covered
Health First Colorado covers what it calls pediatric behavioral therapies, which include ABA, for members 20 and younger. The services must meet the federal EPSDT standard for medical necessity. EPSDT is Medicaid’s benefit for children and young adults, and it requires states to cover treatment a child needs, even when the service isn’t listed for adults.
Two things follow from that:
- A child does not lose coverage at 18. Teenagers and young adults through age 20 can still receive ABA through Health First Colorado. See providers serving teens.
- At 21, the pediatric benefit ends. Adults should ask their plan and their county’s Case Management Agency what else is available. Fewer providers serve adults; here is the list of providers who serve ages 18 and up.
The state’s pediatric behavioral therapies page has the official details.
Every plan needs prior authorization
Before ABA sessions begin, your provider has to get the plan approved. In Colorado this is called prior authorization, and it runs through the state’s contractor, Acentra Health. Families don’t submit the request themselves. The provider does.
According to the state’s information for providers, a request includes:
- a referral for behavioral therapy
- a standardized assessment of your child’s adaptive skills
- a plan of care written by the supervising behavior analyst (BCBA)
An approved authorization lasts up to six months. After that, the provider reassesses your child and asks for a renewal. Expect this cycle for as long as your child is in therapy, and ask your provider when your current authorization ends so a lapse doesn’t interrupt sessions.
What it costs
Health First Colorado covers the therapy itself, so families on the plan usually pay little or nothing for covered sessions. Confirm with Health First Colorado if you have a question about your child’s specific coverage. Families with private insurance pay their plan’s deductible, copays or coinsurance instead, and some kids have both kinds of coverage.
If the request is denied
You have options after a denial. The state lists four:
- Reconsideration. Your provider asks Acentra to look at the request again, often with more documentation.
- A new request. The provider can revise the plan of care and submit again.
- Peer-to-peer review. Your child’s BCBA talks directly with the reviewer about why the hours or services are needed.
- A member appeal. As a Health First Colorado member, you can appeal the decision. Appeals go to the Office of Administrative Courts.
Ask your provider which route they recommend and who will handle the paperwork. Keep copies of every letter you receive.
Where CHP+ fits
Child Health Plan Plus, or CHP+, covers children 18 and under in families that earn too much for Health First Colorado. Its benefits include behavioral health care. We could not confirm from the state’s materials exactly how CHP+ handles ABA, so call your CHP+ plan and ask directly before you assume coverage.
The CES waiver
Some children need more help at home than ABA alone provides. The Children’s Extensive Support (CES) waiver is a Health First Colorado program for children under 18 with developmental disabilities or delays who live at home and need intensive support. It can pay for services such as respite and caregiver education.
You apply through your county’s Case Management Agency. A few examples:
| County | Case Management Agency | Local directory |
|---|---|---|
| Denver | Rocky Mountain Human Services | Denver providers |
| Arapahoe and Douglas | Developmental Pathways | Aurora, Centennial, Parker |
| Adams | Rocky Mountain Human Services | Westminster, Brighton |
| Jefferson | Jefferson County Human Services | Arvada, Lakewood |
| El Paso | The Resource Exchange | Colorado Springs |
| Larimer | Foothills Gateway | Fort Collins, Loveland |
The state keeps the full Case Management Agency directory by county. Each city page in our directory also lists the agency for that county.
What has changed recently
Medicaid ABA in Colorado has been in the news for a year:
- In late 2025, the Governor’s budget proposal included cutting Medicaid reimbursement for pediatric behavioral therapy. Families and providers rallied at the Capitol in November 2025.
- In September 2025, ABA providers and the Colorado Association for Behavior Analysis sued the state over the cuts, arguing they violate mental health parity laws. The case was unresolved when we last checked.
- In February 2026, a federal Inspector General audit found at least $77.8 million in improper fee-for-service Medicaid ABA payments in Colorado for 2022 and 2023, mostly over documentation, billing and credentialing.
- In June 2026, Colorado passed a law requiring ABA providers to apply for licensure. Our guide to HB26-1425 covers what it means.
The audit recommended more documentation checks, so expect providers to ask for more paperwork. Ask how long authorizations are taking now.
Questions to ask a Medicaid ABA provider
- Are you taking new Health First Colorado members right now?
- How long are authorizations taking, and who handles the paperwork?
- When does my child’s current authorization end?
- Who is the BCBA on my child’s case, and how often will they see my child?
- Have you applied for your Colorado ABA license?
If your child doesn’t have a diagnosis or evaluation yet, start with our guide to getting an autism evaluation in Colorado.