Rocky Mountain Health Plans ABA therapy coverage in Colorado

We handle the Rocky Mountain paperwork. You focus on your child.

Rocky Mountain Health plans covers ABA therapy for children with autism in Colorado - and Achieve Behavioral manages the entire process from start to finish.

Authorization. Claims. Reauthorization. We take care of it so you don't have to.

How Rocky Mountain Health Plans covers ABA therapy in Colorado

Colorado autism insurance law requires coverage

Colorado law mandates that health insurance plans, including Rocky Mountain Health Plans, cover ABA therapy for children with autism spectrum disorder. This means your Rocky Mountain plan is required to provide benefits for medically necessary ABA services.

What Rocky Mountain typically offers

✔ BCBA assessments and treatment planning

✔ Direct ABA therapy sessions (in-home, school-based, community-based)

✔ Parent training and caregiver support

✔ Ongoing BCBA supervision and treatment adjustments

Rocky Mountain plan types in Colorado

Rocky Mountain Health Plans offers several plan options in Colorado, including:

✔ Rocky Mountain HMO

✔ Rocky Mountain PPO

✔ Medicaid (Health First Colorado) managed plans

✔ Medicare Advantage plans

✔ Employer-sponsored group plans

Coverage details vary by plan, but all commercial plans are required to cover medically necessary ABA therapy under Colorado law.

The Rocky Mountain authorization process (we handle this)

Step 1: We verify your benefits

Within 48 hours of receiving your intake paperwork, we contact Rocky Mountain Health Plans to verify your coverage, check your deductible, and confirm any out-of-pocket costs.

Step 2: We submit the prior authorization request

ABA therapy requires prior authorization from Rocky Mountain Health Plans. We submit all necessary documentation—including the autism diagnosis, BCBA assessment, and treatment plan—directly to Rocky Mountain.

Step 3: Rocky Mountain reviews and approves

Rocky Mountain typically reviews authorization requests within 10-14 business days. We follow up with Rocky Mountain's review team throughout the process and keep you updated on the status.

Step 4: Therapy begins

Once Rocky Mountain approves the authorization, we match your child with a qualified therapist and begin services. You don't lift a finger.

Step 5: We handle reauthorization

Rocky Mountain authorizations are typically approved for 3-6 months at a time. Before your authorization expires, we submit a reauthorization request with updated progress data. You never experience a gap in services.

What families pay with Rocky Mountain Health Plans

Understanding your out-of-pocket costs

Your out-of-pocket costs depend on your specific Rocky Mountain plan.

Most families pay:

✔ Deductible (if not yet met)

✔ Copay per session (typically $10-$50)

✔ Coinsurance (typically 10-20% of the session cost)

Once you hit your plan's out-of-pocket maximum, Rocky Mountain covers 100% of ABA therapy costs for the rest of the calendar year.

Medicaid (Health First Colorado) families

If you have Rocky Mountain through Medicaid (Health First Colorado), ABA therapy is covered with no copays, deductibles, or out-of-pocket costs.

We tell you what to expect upfront

During the verification process, we'll tell you exactly what your financial responsibility will be—before therapy starts. No surprises.

Why Achieve makes Rocky Mountain Coverage easy

We verify benefits within 48 hours

You submit your intake paperwork. We contact Rocky Mountain and verify your coverage within two business days. You know what to expect before therapy begins.

We handle all authorizations and reauthorizations

You never have to call Rocky Mountain. We submit authorization requests, follow up with Rocky Mountain's review team, and manage reauthorizations before your current approval expires.

We submit all claims directly to Rocky Mountain

After each therapy session, we bill Rocky Mountain directly. You receive an Explanation of Benefits (EOB) in the mail showing what Rocky Mountain paid and what (if anything) you owe.

We keep you informed

If Rocky Mountain requests additional documentation, denies coverage, or requires an appeal—we handle it and keep you updated every step of the way.

Helpful Rocky Mountain Health Plans resources

Rocky Mountain Member Portal

Log in to check your benefits, view claims, and access your health information.

Find a Rocky Mountain Provider

Search for in-network behavioral health providers (Achieve is already in-network).

Rocky Mountain Customer Service

Contact Rocky Mountain with questions about your plan or benefits. Customer Service: 1-800-843-0719

Rocky Mountain Behavioral Health Resources

Learn about mental health and behavioral health coverage.

Health First Colorado (Medicaid)

Information for families with Rocky Mountain through Colorado Medicaid.

Colorado Division of Insurance

File a complaint or learn about your rights as a Colorado insurance consumer.

Common questions about Rocky Mountain ABA therapy coverage

  • Does Rocky Mountain Health Plans cover ABA therapy in Colorado?

    Yes. Colorado law requires Rocky Mountain to cover medically necessary ABA therapy for children with autism. Medicaid plans through Rocky Mountain also cover ABA therapy.

  • Do I need a referral from my pediatrician?

    It depends on your specific Rocky Mountain plan. HMO plans typically require a referral; PPO plans often do not. We'll verify this during the benefits check.

  • How long does Rocky Mountain authorization take?

    Rocky Mountain typically reviews prior authorization requests within 10-14 business days.

  • How many ABA therapy hours does Rocky Mountain cover?

    The number of authorized hours depends on your child's clinical need as determined by the BCBA assessment. Rocky Mountain does not have a predetermined hour cap—coverage is based on medical necessity.

  • What if Rocky Mountain denies coverage?

    If Rocky Mountain denies an authorization request, we file an appeal on your behalf with supporting clinical documentation. Denials are rare when the request is properly documented.

  • Does Rocky Mountain cover parent training?

    Yes. Parent training is a required component of ABA therapy and is covered under your Rocky Mountain benefits.

  • Can I use Rocky Mountain for ABA therapy at home and at school?

    Yes. Rocky Mountain covers ABA therapy in multiple settings—home, school, daycare, and community—as long as the services are medically necessary.

  • What happens when my authorization expires?

    We submit reauthorization requests before your current authorization expires, so there's no gap in services.

  • Does Rocky Mountain cover ABA therapy for children on Medicaid?

    Yes. If you have Rocky Mountain through Health First Colorado (Medicaid), ABA therapy is fully covered with no copays or deductibles.

Colorado locations we serve with Rocky Mountain coverage

✔ Denver

✔ Aurora

✔ Lakewood

✔ Arvada

✔ Westminster

✔ Thornton

✔ Centennial

✔ Littleton

✔ Parker

✔ Castle Rock

✔ Highlands Ranch

✔ Lone Tree

✔ Englewood

✔ Greenwood Village

✔ Cherry Hills Village

✔ Broomfield

✔ Northglenn

✔ Commerce City

✔ Brighton

✔ Wheat Ridge

✔ Golden

✔ Superior

✔ Louisville

✔ Lafayette

✔ Longmont

✔ Boulder

Achieve Behavioral handles the entire Rocky Mountain Health Plans insurance process—from verification to authorization to billing—so you can focus on what matters: your child's progress.