Does Peach State Health Plan Cover ABA Therapy?

Peach State Health Plan's Coverage For ABA Therapy

If you're a parent of a child with autism, you may have heard of Applied Behavior Analysis (ABA) therapy. This type of therapy is an evidence-based approach to helping children with autism develop important skills, such as communication, social interaction, and behavior management. However, ABA therapy can be costly, making it difficult for some families to afford.

That's where Peach State Health Plan comes in. As a provider of Medicaid and PeachCare for Kids, Peach State Health Plan offers coverage for ABA therapy for children with autism. However, there are some important details that parents should be aware of.

First and foremost, Peach State Health Plan requires that ABA therapy be prescribed by a licensed physician or psychologist.

This means that parents cannot simply schedule ABA therapy sessions on their own and expect Peach State Health Plan to cover the costs. Instead, parents must work with their child's healthcare provider to obtain a prescription for ABA therapy.

In addition, Peach State Health Plan has some limitations on the amount of ABA therapy that is covered. The plan covers up to 40 hours of ABA therapy per week, with a maximum of 1,560 hours per year. This may be sufficient for some children, but others may require more intensive therapy.

Peach State Health Plan only covers ABA therapy that is provided by a licensed and certified ABA provider.

This means that parents cannot simply choose any therapist or provider that offers ABA therapy. Instead, they must select a provider that is certified by the Behavior Analyst Certification Board (BACB).

Finally, it's worth mentioning that Peach State Health Plan's coverage of ABA therapy is subject to change. This means that parents should check with the plan regularly to ensure that their child's therapy is still covered.