How to Apply for Colorado Medicaid for ABA Therapy

Can ABA therapy start while Medicaid is pending?

Medicaid pays for ABA once your child is covered and the prior authorization is approved. Coverage can reach back to before you applied, but a late approval for ABA is not guaranteed.

The state says “All behavioral therapies will need to be authorized prior to the start of treatment.” Medicaid billing for ABA services starts only then. Budding Futures files that request once your child has Medicaid coverage; here is how Medicaid ABA therapy in Colorado works from there.

Two things can help while you wait:

• Presumptive eligibility (temporary coverage while you wait) gives children under 19 “immediate temporary medical coverage” (HCPF). Ask about it when you apply.
• Back-coverage: once approved, Medicaid can cover care up to three months before the month you applied. Applications from January 1, 2027 get two months.

Back-coverage is not a promise for ABA. HCPF says a late approval request “does not guarantee that the PAR will be approved or the claim paid” (HCPF policy).

While you wait, get a doctor’s referral, gather school and early intervention records, and call us for a free coverage check.

How do I apply for Health First Colorado for my child?

Use PEAK online. It is the state’s fastest way.

1. Online: go to CO.gov/PEAK. Health First Colorado says “Most people find out right away if they qualify.”
2. By phone: call 1-800-221-3943, Monday to Friday, 8 a.m. to 4 p.m.
3. By mail: print the paper application from Health First Colorado’s website.
4. In person: go to your county human services office or a local application assistance site.

After you apply, “You can check your application status online” in PEAK.

Does my child qualify for Health First Colorado?

Most Colorado families with children qualify by household income.

Source: Health First Colorado, 2026 table.

For ABA, the Pediatric Behavioral Therapies benefit covers children and young adults age 20 and under under EPSDT (Early and Periodic Screening, Diagnostic and Treatment) when therapy is medically necessary. Medical necessity decides, not an autism spectrum disorder diagnosis.

Children 18 and younger have no co-pays, and “There are no co-pays for behavioral health” services in Colorado’s Medicaid program (member handbook).

What if our income is too high for Medicaid?

Your child may still qualify through a disability program.

• Buy-In program for children with disabilities: income up to “300% of the FPL for children” (HCPF).
• Children’s Extensive Support (CES) waiver: for children who “Are age 0-17 and live at home” and have an intellectual or developmental disability, or a developmental delay under age 5 (HCPF).

A child on the CES waiver can still get ABA therapy through Health First Colorado.

Does CHP+ cover ABA therapy?

No. CHP+ does not cover ABA therapy.

HCPF’s provider training says: “Applied Behavior Analysis (ABA) therapy is not covered by CHP+.” Colorado Access and Denver Health say the same for their CHP+ plans.

CHP+ is for families just over the Medicaid limit: $3,906 to $7,150 a month for a family of four (Connect for Health Colorado).

CHP+ (Child Health Plan Plus) is low-cost health coverage, but ABA is not one of its covered services. For a CHP+ family, ask whether your child qualifies for the Buy-In program or the CES waiver, and check any private health insurance through a parent’s job. We can look at the options with you on a free call.

What happens after my child is approved?

Therapy can start in five steps.

1. Get a referral from a doctor or other provider enrolled with Health First Colorado.
2. Call Budding Futures. We check your coverage for free.
3. A Board Certified Behavior Analyst (BCBA) assesses your child at home and writes the treatment plan with measurable goals.
4. We send the prior authorization request with the clinical documentation to the state’s utilization management vendor, the company that reviews requests. The standard review time is “seven (7) calendar days” (HCPF bulletin). If hours are cut, a peer-to-peer review and your right to appeal still apply.
5. Therapy starts at home. There is no waitlist right now.

Under 3? Early intervention ABA starts from 18 months.

Where Budding Futures fits

We help your family from the first call to the first session.

• Budding Futures is enrolled with Health First Colorado under Provider Types 83 and 84.
• We check your coverage for free and file the prior authorization request.
• Therapy happens at home: in-home ABA therapy anywhere in Colorado.
• The same RBT works with your child each week, and Rachel Blackburn, BCBA writes every treatment plan.
• What we do not do: we do not run a clinic or center.

Call (720) 613-8837 or send the form.

Facts come from Health First Colorado, HCPF, CMS, Colorado Access, Denver Health and Connect for Health Colorado. These are outside sources, not affiliated with Budding Futures. Income limits change each year; check the state’s table before you apply. This is general information, not legal advice.