Does Health First Colorado cover ABA therapy in Denver?

Yes. Health First Colorado, the state's Medicaid program, covers ABA therapy for children under 21 with an autism spectrum disorder diagnosis. Coverage includes in-home, school-based, and community sessions across Denver and the rest of Colorado. Most families pay nothing out of pocket for approved hours.

Which Medicaid plan covers Denver families for ABA?

Most Denver County families are enrolled with Colorado Access (a Regional Accountable Entity under HCPF's Phase III contracts effective 2025-07-01) or with Elevate Medicaid Choice, Denver Health's Managed Care Organization. Each runs its own provider network. Budding Futures bills both, plus Rocky Mountain Health Plans, Northeast Health Partners, and Colorado Community Health Alliance for families in other regions of Colorado.

How does the Prior Authorization Request work?

After a diagnosis and assessment (usually VB-MAPP or ABLLS-R), the BCBA submits a Prior Authorization Request to your child's RAE or MCO. The PAR documents medical necessity and proposes weekly hours, typically 10 to 40. Approval covers a six-month window. Re-authorizations renew the same way. We track the calendar so hours don't lapse.

What if my child has both private insurance and Medicaid?

Health First Colorado acts as the secondary payer when private insurance is in place. Private insurance is billed first. Whatever isn't covered (deductibles, copays, exhausted hours) shifts to Medicaid. We coordinate both submissions so the family doesn't get a bill in the middle.

What if my Medicaid PAR is denied?

You can request a peer-to-peer review, supply additional clinical documentation, or file a formal appeal through Health First Colorado. Most denials reverse with a corrected resubmission rather than a hearing. Budding Futures runs all three steps as part of the service so families don't navigate appeals alone.

Medicaid ABA Therapy in Denver and Across Colorado: How Health First Colorado, Colorado Access, Rocky Mountain Health Plans, and Elevate Medicaid Choice Cover ABA, the PAR Process, and What Families in Each City Pay

Does Health First Colorado Cover ABA?

Yes. Health First Colorado is the state's Medicaid program, and it pays for ABA therapy for any child under 21 with an autism diagnosis. We work in your kitchen. We work in clinics when that's what a family wants. When a school district lets us in, we run sessions in the classroom too. Park trips and grocery runs count as therapy when the goal is community skills. Most of our families pay nothing for any of it. After the assessment, the BCBA writes a Prior Authorization Request and the plan signs off on a rolling six-month window.

That part's the straightforward bit. The messy part is which Medicaid plan you're actually on. Two parents on the same block in Park Hill can run into completely different walls depending on whether their child shows up under Colorado Access or under Elevate Medicaid Choice through Denver Health. Most ABA agencies in this state are only credentialed with one of them, which is the catch nobody warns you about.

Which Medicaid Plan Are You Actually On?

On July 1, 2025, the state moved Colorado's Accountable Care Collaborative into Phase III and shrank the behavioral health regions from seven down to four. So today we're dealing with four Regional Accountable Entities (RAEs), plus one Managed Care Organization (MCO) called Elevate Medicaid Choice that Denver Health runs. Your child sits inside one of those, and that's the one that decides whether ABA gets paid.

Region / Plan	Organization	Phone
Region 1 RAE	Rocky Mountain Health Plans (RMHP)	(800) 421-6204
Region 2 RAE	Northeast Health Partners	(800) 541-6870
Region 3 RAE	Colorado Community Health Alliance	(855) 627-4685
Region 4 RAE	Colorado Access	(800) 511-5010
MCO option	Elevate Medicaid Choice (Denver Health)	(855) 281-2418

Source: Colorado Department of Health Care Policy & Financing, ACC Phase III contracts effective 2025-07-01.

Denver County families usually end up with Colorado Access or with Elevate Medicaid Choice through Denver Health. Aurora and Westminster families lean Colorado Access too. Down south and east of metro Denver, you'll see Colorado Community Health Alliance show up. Northeast of the city, it's Northeast Health Partners. The Western Slope and the mountains? Rocky Mountain Health Plans, every time. If you're not sure which one your child sits with, log into healthfirstcolorado.com or call (800) 221-3943.

Why I'm laying this out: every RAE and the MCO run their own credentialed network. A provider on Colorado Access doesn't automatically bill Elevate Denver Health. The reverse is also true. We bill all four RAEs and the Elevate MCO, which is unusual in Colorado. Most agencies pick one and stick with it.

How the PAR Process Actually Works

Once your child is matched with a Medicaid-enrolled provider, the BCBA writes the Prior Authorization Request. That packet pulls together the diagnosis along with assessment results (usually a VB-MAPP or ABLLS-R) and the proposed weekly hours, which normally land somewhere between 10 and 40 depending on the child's age and goals. The plan then reviews medical necessity and approves a six-month window of hours, with renewals running through the same process. Our team watches the calendar so hours don't lapse while paperwork's getting filed.

Coverage by City — Denver and Beyond

Budding Futures delivers Medicaid-covered ABA across Colorado:

Denver: Berkeley, Highland, Capitol Hill, Cherry Creek, Park Hill, Green Valley Ranch, Westwood, Gateway. Mostly Colorado Access or Elevate Medicaid Choice.
Aurora: Original Aurora, southeast metro, GVR border. Aurora Medicaid spoke →
Lakewood, Arvada, Wheat Ridge, Westminster: West and north metro.
Littleton, Centennial, Highlands Ranch: South metro.
Boulder, Fort Collins: Northern Front Range.
Colorado Springs, Pueblo: Southern Colorado.
Grand Junction: Western Slope, RMHP territory.

We coordinate the provider network for each, so families don't have to chase down which carrier covers them.

What If Your Child Has Dual Coverage?

Plenty of families carry a private plan and Health First Colorado at the same time. When that happens, Medicaid quietly slides into the secondary slot behind your commercial plan. Your private insurance gets billed first. Anything left over (a copay, a chunk of hours after a private plan caps out, a denied service Medicaid still pays for) shifts to Health First Colorado. We coordinate both submissions so a bill doesn't show up halfway through the school year.

If Your PAR Gets Denied

Denials happen. Most often it's because an assessment is missing data, or because the requested hours fall outside the expected range for the diagnosis. The first move is usually a peer-to-peer review with the plan's medical director. The second move, if that doesn't resolve it, is to add clinical documentation and resubmit. The last resort is a formal appeal through Health First Colorado. Most denials reverse on the corrected resubmission. Rachel Blackburn, BCBA, runs every step.

How Budding Futures Handles the Medicaid Side

Rachel oversees every treatment plan and every PAR. Before we even start the assessment, our team verifies your RAE and confirms enrollment status. From there we file the auth, track the calendar so hours don't lapse, and run the appeal whenever a plan tries to slow things down. You don't run the paperwork. We do. Call (720) 613-8837 or email info@buddingfuturesaba.com and we'll check your plan, your benefits, and your city in one conversation.