How to Access ABA Therapy Service

Medicaid Funded Plans (CMS, Sunshine, Aetna Better Health, Humana Healthy Horizons, Simply/Carelon)

Commercial/Private Insurance Plans (Aetna, BCBS, ChampVA, Cigna, Tricare)

Welcome & Next Steps for ABA Therapy Services

What to Expect Next

We understand that gaining initial authorization for ABA services can feel overwhelming. To make this process easier, we’ve included a step-by-step list of Insurance-mandated requirements and helpful documents to get you started .

🧾 Let’s Get Started

Please click this link to get you started.

We understand that gaining initial authorization for ABA services can feel overwhelming. To make this process easier, we’ve included a step-by-step list of insurance-mandated requirements and helpful documents to get you started ✅.

Once we receive the necessary forms from you and the referring physician, your child will be placed on our waitlist.

Attached Documents

1. 📄 Welcome Flyer – Overview of our services + helpful tips
2. 🗂 Intake Packet – Helps us gather essential information
3. 💳 Payment Policy & Credit Card Authorization Form – Required once your case is opened (does not apply to Medicaid Funded Plans

📌 Insurance Requirements

• Must be on an official script pad
• Signed by an in-network MD/DO
• Must state: “ABA services are Medically Necessary”
• Must include a specific mental health diagnosis
• An F84.0 (Autism) diagnosis is a requirement for private insurance to cover ABA

• Parent/guardian interviews
• Teacher assessments
• Diagnostic tools (e.g., ADOS-2, CARS2, M-CHAT-R, CSBS, etc.)
• Hearing & vision screenings
• Genetic or neurological testing as needed

• Developmental Pediatricians
• Child Neurologists
• Child Psychologists or Psychiatrists

• Background and presenting concerns
• Clinical findings
• Diagnostic recommendations
• Diagnostic Tools/tests used
• Summary and next steps
• Treatment recommendations, to include ABA therapy
• F-code for diagnosis
• Signature required

📤 What You Need to Send

1. 🪪 Copy of the front and back of your insurance card
2. 📚 Detailed developmental & medical history, including:
• Records from previous clinicians
• Most recent pediatric visit summary
3. 🧠 Developmental, Cognitive & Neurological evaluations
4. 💊 List of current medications + prescribing physician
5. 🧩 Adaptive behavior assessment (if available)
6. 🏥 Medical history, including:
• Injuries, hospitalizations, surgeries
• Co-morbid diagnoses & allergies

⏳ Next Steps

📞 Questions or Need Help?