ABA insurance and Medicaid coverage in Colorado
Last researched October 21, 2026
Who pays for ABA in Colorado, and what a practice has to do to bill them. Coverage details here come from statutes and agency pages we read, not from payer marketing.
Autism insurance mandate
- State mandate for autism coverage
Yes, the research found a state autism coverage law.
- Statute
C.R.S. 10-16-104(1.4) and (5.5), verified in the 2026 Colorado Revised Statutes.
- Age limits
Autism Speaks reports no autism-specific age cap following SB15-015, effective 2017-01-01. Subsection (1.4)(b)(I) still refers to coverage for a child; subsection (5.5) separately includes ASD in broader mental-health parity coverage.
- Annual cap
No autism-specific annual dollar cap, according to Autism Speaks. Subsection (1.4)(e) prohibits dollar limits and cost sharing less favorable than those applicable to physical illness.
- Excludes self-funded employer plans
Yes, self-funded employer plans are generally outside state mandates.
- Notes
State-regulated plans must cover ASD assessment, diagnosis and medically necessary treatment, including ABA consultation, direct care and supervision. Treatment requires a licensed physician's or psychologist's order. Subsection (1.4) excludes short-term limited-duration and individual grandfathered plans. The legislature's 2020-03-09 memorandum confirms self-funded plans are outside Colorado benefit mandates. Section (1.4)(a)(II)(F) recognizes technicians nationally registered by BACB or a similar nationally recognized organization and supervised by another qualifying autism services provider. It does not expressly recognize an unregistered BT through that pathway; carrier-specific reimbursement remains unverified. Confidence is medium because the explicit no-age-cap interpretation relies on Autism Speaks. General information, not legal advice.
Medicaid ABA coverage
- Medicaid covers ABA
Yes, per the sources below.
- Program
Health First Colorado (Colorado's Medicaid program) Pediatric Behavioral Therapies (PBT) Benefit (members 20 years old and younger who meet EPSDT medical necessity criteria for behavioral therapy services, per the HCPF PBT manual on the HCPF test site)
- Agency
Colorado Department of Health Care Policy & Financing (HCPF)
- Provider enrollment
We could not verify this yet - check with Colorado Department of Health Care Policy & Financing (HCPF).
Payers named in our research
We could not verify named payers for Colorado yet - check with the state Medicaid agency.
How to enroll
- We could not verify the Medicaid provider enrollment page for Colorado yet - check with the state Medicaid agency.
- Ask each commercial payer you want to bill for its credentialing application and timeline. We have not verified payer timelines.
- Confirm which staff types the payer reimburses, including whether technicians must hold the RBT credential. See BT vs RBT in Colorado.
Related guides for Colorado
Spotted something out of date? Tell us through our editorial policy page. We re-check these guides on a schedule and show the date above.