Applied Behavioral Analysis (ABA) therapy is an approach that uses positive reinforcement to improve behaviors and social interactions and decrease inappropriate behaviors. Education of the member and their caregivers is completed to reinforce positive behaviors in an effort to help the member accomplish activities of daily living (ADL’s). Below are the DHMP benefits by line of business (LOB) for Applied Behavior Analysis (ABA).

Medicaid

  • Managed by State of Colorado
    ABA therapy is a WRAP benefit for Medicaid members. Benefits are administered exclusively by the State for review and subsequent approval or denial. DHMP has no authority over any Wrap Benefit and therefore DHMP-UM cannot issue an approval or denial. Submit prior authorization requests to the State of Colorado.

Children Health Plan Plus (CHP+)

  • Not a Covered Benefit
    ABA is not a covered benefit for DHMP or the state for CHP+ members.

All Commercial Plans

  • Managed by Denver Health Medical Plan (DHMP)
    DHMP requires authorization for ABA therapy services. ABA therapy is allowed currently for all Commercial LOB with a confirmed diagnosis of autism.

 

Applied Behavioral Analysis (ABA) therapy is an approach that uses positive reinforcement to improve behaviors and social interactions and decrease inappropriate behaviors. Education of the member and their caregivers is completed to reinforce positive behaviors in an effort to help the member accomplish activities of daily living (ADL’s). Below are the DHMP benefits by line of business (LOB) for Applied Behavior Analysis (ABA).

Medicaid

  • Managed by State of Colorado
    ABA therapy is a WRAP benefit for Medicaid members. Benefits are administered exclusively by the State for review and subsequent approval or denial. DHMP has no authority over any Wrap Benefit and therefore DHMP-UM cannot issue an approval or denial. Submit prior authorization requests to the State of Colorado.

Children Health Plan Plus (CHP+)

  • Not a Covered Benefit
    ABA is not a covered benefit for DHMP or the state for CHP+ members.

All Commercial Plans

  • Managed by Denver Health Medical Plan (DHMP)
    DHMP requires authorization for ABA therapy services. ABA therapy is allowed currently for all Commercial LOB with a confirmed diagnosis of autism.