🛡 Cigna Coverage Guide — Colorado

Does Cigna Cover ABA Therapy in Colorado?

In most cases, yes. Colorado law requires state-regulated health plans to cover ABA therapy for autism with no age limit and no dollar cap, as of January 2017. Cigna covers ABA therapy when medically necessary. Confirm your specific plan with a Verification of Benefits before starting.
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Does Cigna cover ABA therapy in Colorado?

Colorado's original autism insurance mandate (SB 09-244, 2010) required commercial health plans to cover ASD diagnosis and treatment, including ABA therapy, for individuals under 19. A follow-up law (SB 15-015) removed those age and dollar caps effective January 1, 2017 — Colorado's mandate now applies at any age, with no cap. Fully-insured individual and small-group plans are regulated by Colorado law and must follow this mandate. Many large-employer plans are self-funded and governed by federal ERISA instead. Colorado Medicaid (Health First Colorado) separately covers ABA therapy for children and teens up to age 21, including evaluations, daily sessions, and parent training. Cigna's own coverage policy states ABA therapy is covered for autism spectrum disorder when medically necessary, with details varying by plan.

What does Cigna require before ABA therapy starts in Colorado?

Cigna has a two-step process for ABA authorization in Colorado:

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    Assessment (no prior auth needed)

    Prior authorization is not required for the initial ABA assessment (CPT 97151, 97152, or 0362T) if performed by an independently licensed clinician or BCBA, and the policy covers ABA.

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    Treatment plan authorization

    After the assessment, the provider submits an ABA Prior Authorization Form with the treatment plan — recommended up to 30 days before, or within 2 weeks after, the planned start date.

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    CPT codes

    All ABA services are billed under CPT codes 97151–97158, 0362T, and 0373T, including telehealth. Plan questions: Cigna's Autism Care Coordinator team, 877.279.7603.

How do I verify my exact Cigna plan covers ABA therapy?

Call the member services number on your Cigna card and request a Verification of Benefits. Confirm: ABA coverage, prior authorization requirements, session caps, deductible, copay, out-of-pocket maximum.

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Frequently Asked Questions

Is there an age limit on ABA therapy coverage under Cigna in Colorado?
No. Colorado removed age and dollar caps on ABA coverage effective January 1, 2017 (SB 15-015). This applies to state-regulated fully-insured plans; confirm with Cigna whether your specific plan is fully-insured or self-funded, since the two are treated differently.
Is my Cigna plan definitely covered by Colorado's autism mandate?
Only if it's a fully-insured individual or group plan regulated by Colorado. Many large-employer plans are self-funded under federal ERISA instead, which the state mandate doesn't reach — though many self-funded employers cover ABA voluntarily.
Does Colorado Medicaid cover ABA therapy too?
Yes. Health First Colorado covers ABA therapy for children and teens up to age 21, including evaluations, daily sessions, and parent training, separately from the commercial insurance mandate.

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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 July 2026. Coverage terms and provider availability change frequently — verify directly with your insurance carrier and the provider before scheduling.