๐Ÿ›ก Blue Cross Blue Shield Coverage Guide โ€” Colorado

Does Blue Cross Blue Shield Cover ABA Therapy in Colorado?

In most cases, yes. Colorado's autism insurance mandate (SB 15-015, effective July 1, 2017) requires state-regulated health plans to cover ABA therapy for autism with no age limit and no annual dollar cap. In Colorado, Anthem Blue Cross Blue Shield of Colorado is the primary BCBS licensee. Confirm your specific plan with a Verification of Benefits before starting.
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Does Blue Cross Blue Shield cover ABA therapy in Colorado?

Colorado's autism insurance mandate (SB 15-015, effective July 1, 2017) requires state-regulated health insurance plans to cover the diagnosis and treatment of autism spectrum disorder, including ABA therapy, with no age limit and no annual dollar cap. In Colorado, Anthem Blue Cross Blue Shield of Colorado is the primary BCBS licensee. Self-funded employer plans governed by federal ERISA are generally exempt from this state mandate. BCBS covers ABA therapy for autism spectrum disorder when the plan includes the benefit and treatment is medically necessary.

What does Blue Cross Blue Shield require before ABA therapy starts in Colorado?

Most BCBS plans in Colorado require prior authorization before ABA services begin:

  • โœ“
    Formal ASD diagnosis

    A formal ASD diagnosis from a licensed psychologist or developmental pediatrician is required before submitting a treatment plan.

  • โœ“
    Comprehensive treatment plan

    BCBS typically requires a treatment plan with measurable goals, assessment results, weekly therapy hours, and the BCBA's credentials before authorizing ABA services.

  • โœ“
    Authorization renewal

    Authorizations are typically reviewed periodically. Call the member services number on your BCBS card to confirm your plan's specific authorization process.

BCBS ABA therapy in the Denver metro and Colorado Springs

Families across the Denver metro โ€” including Denver, Aurora, Lakewood, Thornton, Arvada, Westminster, Centennial, and Highlands Ranch โ€” and in Colorado Springs and the Front Range frequently ask whether BCBS covers ABA in their area. Coverage follows Colorado's statewide SB 15-015 rules regardless of which city you are in; what varies is provider availability and network status. Harmony Care Finder's provider network spans the Front Range, so one coverage check surfaces in-network BCBS options closest to you.

How do I verify my exact Blue Cross Blue Shield plan covers ABA therapy?

Call the member services number on your BCBS card and request a Verification of Benefits. Confirm: ABA coverage, prior authorization requirements, deductible, copay, and out-of-pocket maximum. Ask specifically whether your employer plan is fully-insured (covered by Colorado's mandate) or self-funded.

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Frequently Asked Questions

Does Blue Cross Blue Shield cover ABA therapy in Colorado?
Yes. Blue Cross Blue Shield covers ABA therapy for autism in Colorado when medically necessary. Colorado's SB 15-015 mandate requires state-regulated plans to cover ABA therapy with no age limit and no annual dollar cap. In Colorado, Anthem Blue Cross Blue Shield of Colorado is the primary BCBS licensee. Confirm your specific plan's details directly.
Is there an age limit on ABA therapy coverage under BCBS in Colorado?
No. Colorado's autism insurance mandate has no age limit and no annual dollar cap on ABA coverage. However, self-funded employer plans under federal ERISA may not be subject to this mandate.
Does BCBS require prior authorization for ABA therapy in Colorado?
Yes. BCBS plans typically require prior authorization for ABA therapy. Your BCBA must submit an initial treatment plan and assessment for approval. Call the member services number on your BCBS card to confirm your plan's specific process.

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Let us check your benefits and match you with Colorado providers who accept Blue Cross Blue Shield. It's free.

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๐Ÿข Blue Cross Blue Shield ABA Coverage Overview ยท ๐Ÿ“ ABA Providers in Colorado ยท โœ“ Check Your Coverage
Reviewer Pending

This page is pending review by a named BCBA or BCBA-D. A working BACB Certificant Registry link will be added once a reviewer is confirmed.

Sources

This content is for informational purposes only and does not constitute medical, clinical, or therapeutic advice. Consult a licensed healthcare provider or Board Certified Behavior Analyst (BCBA) before making therapy decisions for your child.

Data current as of August 2026. Coverage terms and provider availability change frequently โ€” verify directly with your insurance carrier and the provider before scheduling.