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.
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
We manage Health First Colorado so you don't have to.
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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.
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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.
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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.
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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.
Everything your child needs, authorized through EPSDT.
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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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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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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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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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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.
Does my child qualify?
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Age
Under 21. Coverage ends at the 21st birthday.
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Diagnosis
A formal Autism Spectrum Disorder diagnosis from a licensed clinician is the standard pathway.
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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.
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 RAE below for the authorization details that apply to your family.
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.
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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
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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
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If things go sideways
- 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
Katie Beckett, HCBS waivers, and Early Intervention.
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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.
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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.
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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.
Questions Health First Colorado families ask us
Is there a cap on how many ABA hours Health First Colorado will cover?
No. The EPSDT benefit prohibits arbitrary hour or dollar caps for children under 21. Coverage is based on what your child's BCBA assessment documents as medically necessary. Typical authorizations range from 10 to 40 hours per week.
Does my child need an autism diagnosis to qualify?
An official ASD diagnosis is the standard pathway. We confirm your child's specific eligibility on the first call.
How do I know which RAE my child is assigned to?
Find your county in the table above. If you're unsure, our enrollment team confirms your RAE assignment on the first call.
What does it cost my family?
For most Health First Colorado families, ABA therapy costs nothing out of pocket. We verify your exact financial responsibility before your child's first session.
What if my child has both Medicaid and a commercial plan?
Medicaid coordinates as the secondary payer. We handle the coordination between both plans.
What happens when my child turns 21?
Coverage ends at the 21st birthday. Call us before that date to discuss what comes next.
Let's Get Your Child's Health First Colorado Therapy Authorized
We've worked with every variety of Health First Colorado case across all four RAE regions. This is what we do every day.