IllustrationHow much does ABA therapy cost with Medicaid in Colorado, and without it?
ABA therapy through Health First Colorado usually costs the family $0, because the state pays the provider directly once the prior authorization is approved.
Does Colorado Medicaid cover ABA therapy for your child? Eligibility in short
If your child is enrolled in Health First Colorado, the Pediatric Behavioral Therapies benefit covers ABA when a provider shows it's medically necessary. There's no autism diagnosis requirement on the state's page and no fixed cap on therapy hours; the approved plan sets the hours, for up to six months at a time.
To qualify for Medicaid itself, the family's income has to fall under the state's limit for the child's age group, or the child has to qualify through a disability route. Families over the limit whose child has a disability can apply for the Children's Buy-In Program, which comes with a monthly premium. An insurance plan from a parent's job doesn't stop a child from having Health First Colorado as a second plan.
What the state pays
The July 2026 fee schedule pays $17.20 per 15 minutes for CPT code 97153, the one-to-one ABA code, with prior authorization required. A year earlier it was $18.17. The schedule does not set a cap on hours; the approved plan does.
That rate is what providers mean when they talk about Medicaid paying less than private insurance. It is also why some providers limit the number of Medicaid families they take.
“I'm hearing from providers all across the state of 10%, 15%, 20% rate cuts and also now a cap on services, so this seems really unfair”
What can still cost you
- Children's Buy-In premiums. If your family earns too much for Health First Colorado and your child has a disability, the Buy-In program charges a monthly premium printed on the state's page as $0, $70, $90 or $120, depending on income.
- Hours beyond the approved plan. If you want more hours than the state approved, the provider may offer them privately.
- Travel outside a provider's stated area, if it agrees to come at all.
- Things that are not therapy: evaluations by a private psychologist, materials, camps.
When you also have private insurance
The employer plan pays first and Health First Colorado second, which usually wipes out the copay. Give the provider both cards on the first call; billing the wrong one first delays everything. Colorado's autism coverage law for state-regulated plans removed age and dollar caps in 2017, according to Autism Speaks' summary; this site has not yet read the statute itself.
ABA therapy cost in Colorado without insurance
Private-pay prices are the provider's own. Some print an hourly rate; most don't. This site prints no price it hasn't read on a provider's site, so ask directly and get it in writing.
As a yardstick, the state's rate for the main ABA code works out to $68.80 an hour ($17.20 per 15 minutes). A plan of ten hours a week at that rate would be about $35,800 a year, and that's the Medicaid rate, which providers say is below what private insurance pays. Our arithmetic, from the state's July 2026 fee schedule, not a provider's price.
| Hours a week | At the state's rate ($68.80 an hour) | Per year (52 weeks) |
|---|---|---|
| 5 | $344 a week | about $17,900 |
| 10 | $688 a week | about $35,800 |
| 20 | $1,376 a week | about $71,600 |
Our arithmetic on the Health First Colorado rate for CPT 97153, July 2026. Private-pay prices are set by each provider and are usually higher.
Financial assistance when Medicaid isn't an option
- The Children's Buy-In Program for children with a disability, with a monthly premium the state prints as $0 to $120.
- A parent's employer plan: Colorado's autism insurance law covers ABA on state-regulated plans with no age or dollar cap, according to Autism Speaks' summary. Self-funded plans may differ.
- Early Intervention Colorado for a child under 3, at no cost to the family, through the state line at 833-733-3734.
- Ask each provider whether it offers a sliding scale or a payment plan. Some do; none are required to.
What's in the price: the BCBA, the technician and the hours
Whatever the payer, the cost of ABA therapy is mostly people's time. A board certified behavior analyst writes and supervises the treatment plan; a behavior technician delivers most of the direct therapy sessions. More hours a week means a higher annual cost, which is why the prior authorization sets the hours and why your out-of-pocket cost on Medicaid stays at zero regardless of them.
Find a provider in your city
Denver, Colorado Springs, Aurora, Fort Collins, Lakewood, Boulder, Pueblo, Greeley, Longmont, Thornton, or the whole state list with filters.
Questions about ABA therapy costs in Colorado
Is there a copay for ABA on Health First Colorado?
The state's benefit page does not list one for this benefit. Families on the Children's Buy-In pay a monthly premium instead, printed as $0 to $120 on the Buy-In page.
Can a provider bill me the difference between its rate and Medicaid's?
Ask the provider and the Member Contact Center at 1-800-221-3943 before you sign anything. Enrolled providers agree to the state's terms for covered services.
How much does ABA cost without Medicaid in Colorado?
It depends on the provider and the hours. The providers on this site that print a price have it quoted on their profile; the rest do not publish one.
Sources
- HCPF provider rates and fee schedules (July 2026 fee schedule)https://hcpf.colorado.gov/provider-rates-fee-schedule
- Medicaid Buy-In Program for Children with Disabilitieshttps://hcpf.colorado.gov/medicaid-buy-program-children-disabilities
- Health First Colorado: Pediatric Behavioral Therapieshttps://hcpf.colorado.gov/pediatric-behavioral-therapies
- CBS Colorado, 18 November 2025https://www.cbsnews.com/colorado/news/colorado-families-providers-medicaid-autism
- Autism Speaks: Colorado state-regulated insurance coverage (summary, not the statute)https://www.autismspeaks.org/colorado-state-regulated-insurance-coverage
Every quote on this page was matched word for word against the source on 18 October 2026.