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If you’re a parent of a child with autism in Colorado, understanding Medicaid coverage for Applied Behavior Analysis (ABA) therapy is essential. Colorado’s Medicaid program, Health First Colorado, offers significant support by covering ABA services for eligible children. In this article, we’ll explain what services are covered, their importance, and Colorado-specific benefits that can help your child thrive.
What ABA Services Are Covered by Health First Colorado?
Medicaid in Colorado covers a range of essential ABA services that support your child’s behavioral development. Here’s a breakdown of the services and why they are critical:
A Comprehensive Behavioral Assessment is a thorough evaluation of your child’s behavioral patterns, strengths, and challenges, typically performed by a Board Certified Behavior Analyst (BCBA). This assessment is critical for identifying your child’s specific needs and crafting a tailored treatment plan for their ABA therapy. By focusing on your child’s individual behaviors, it ensures that the therapy targets the right areas and promotes the best possible outcomes.
Individualized Therapy Sessions are one-on-one sessions between your child and a Registered Behavior Technician (RBT), concentrating on specific behavioral goals. Since every child’s needs are unique, these sessions are personalized to address individual challenges. The therapy provides direct intervention to encourage positive behaviors while addressing negative ones, making this the core component of ABA therapy.
Parent Training involves structured sessions where parents and caregivers are taught how to apply ABA techniques at home. ABA therapy is most effective when consistently reinforced in both the therapy setting and daily life. Parent training empowers you to understand and implement the strategies used in therapy, allowing for better long-term success for your child by practicing techniques in everyday situations.
Ongoing Progress Monitoring is the continuous supervision of your child’s development by a BCBA. As children grow, their needs change, and regular progress monitoring ensures that their therapy is adjusted accordingly. This dynamic approach makes sure that the treatment remains effective over time and evolves with your child’s progress.
Social Skills Training helps children improve their ability to interact with others, understand social cues, and navigate relationships. Many children with autism struggle with social interactions, so this training is key to helping them build friendships and communicate effectively. By improving their social life and emotional well-being, it has a significant positive impact on their daily interactions.
Group Therapy Sessions provide children with opportunities to practice behavioral and social skills in a group setting. These sessions are especially useful for children to apply what they’ve learned in a more social context, practicing essential skills such as sharing, taking turns, and cooperating. Group settings help reinforce behaviors in real-world environments, making them more natural for children.
Lastly, Crisis Intervention offers emergency behavioral support during severe episodes. These services aim to calm situations quickly and provide immediate care. For children with autism who may experience extreme behavioral outbursts, crisis intervention is crucial in de-escalating dangerous situations and preventing harm to the child or those around them.
What Colorado Programs Support ABA Therapy?
In Colorado, Medicaid offers additional services and waivers designed to support children with autism and developmental disabilities. Here’s a closer look at Colorado-specific programs you should know about:
Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)
The EPSDT program ensures that children under 21 enrolled in Health First Colorado receive medically necessary services, including ABA therapy. EPSDT guarantees that there are no strict limits on the amount of therapy your child can receive if deemed necessary by their provider.
Children’s Extensive Support (CES) Waiver
This waiver covers services beyond what Medicaid typically offers. The CES waiver provides extra assistance like in-home support, respite care, and home modifications, making it a valuable resource for families of children with significant disabilities who may need additional care alongside ABA therapy.
Family Support Services Program (FSSP)
FSSP provides financial support for non-Medicaid covered services, such as copays, parent training, or the cost of home care. This program can be a lifeline for families needing additional resources beyond what Medicaid provides.
What are RAEs
In Colorado, Medicaid services are organized through Regional Accountable Entities (RAEs), which play a vital role in coordinating your child’s care. RAEs connect you to local Medicaid-approved ABA providers, help manage referrals, and ensure that your child receives integrated care across different healthcare services. Depending on your location, your RAE can provide personalized support and help streamline your access to ABA therapy and related services.
Medicaid and Telehealth ABA Therapy in Colorado
Colorado Medicaid offers telehealth coverage for ABA therapy, providing families with flexibility, especially those in rural or underserved areas. Telehealth sessions allow your child to receive therapy virtually, ensuring continuity of care without the need for long-distance travel. Ask your ABA provider if they offer telehealth as part of their Medicaid services.
Example of Income Limits for Colorado Medicaid (2024)
To qualify for Health First Colorado, your household income must fall below certain thresholds. Below is a table that outlines the income limits for Colorado Medicaid in 2024. These limits are based on a percentage of the Federal Poverty Level (FPL)
| Family Size | 2023 Income Limits | 2024 Income Limits |
| 1 | $14,580 | $15,060 |
| 2 | $19,720 | $20,440 |
| 3 | $24,860 | $25,820 |
| 4 | $30,000 | $31,200 |
| 5 | $35,140 | $36,580 |
For families larger than five, add $5,380 for each additional family member.
Bright Pathways ABA Is Here to Help
Navigating Colorado Medicaid to access ABA therapy can feel overwhelming. At Bright Pathways ABA, we specialize in working with Health First Colorado to ensure that your child receives top-notch care. Our services include individualized therapy, parent training, and support for telehealth options. Contact us today to learn how we can assist your family in securing Medicaid-covered ABA therapy that meets your child’s unique needs.
Disclaimer
The information provided in this article is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Bright Pathways ABA does not assume any responsibility for any outcomes or consequences resulting from the use of this information. Always seek the advice of a qualified healthcare provider with any questions regarding a medical condition or behavioral intervention.
