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Great News for Georgia Medicaid Members!

Level Ahead ABA proudly accepts Georgia Medicaid Insurance for ABA therapy services!

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Your child's path to a personalized ABA therapy is just a step away. Contact us now to verify your coverage and begin services!

Does Georgia Medicaid Cover ABA Therapy?

Yes, Medicaid covers ABA therapy in Georgia. For a child to be eligible for ABA therapy coverage under Georgia Medicaid, they must have a formal diagnosis of ASD, adhering to DSM-5 standards. This diagnosis includes both a medical code and a level of severity for autism. It's important to note that Medicaid covers ABA therapy only for certain diagnoses, and services won't be approved if the child does not meet these specific diagnostic criteria​​.

 Applied Behavior Analysis (ABA) therapy , a crucial intervention for children with Autism Spectrum Disorder (ASD), has been covered by Georgia Medicaid since January 2018. This inclusion marks a significant step forward, expanding access to ABA therapy for families across Georgia and providing assistance with therapy costs, depending on specific plan benefits​​.

Overview of ABA Therapy and Georgia Medicaid Coverage

Process of Obtaining a Diagnosis


To secure the correct diagnosis, families typically need to consult a specialist, which can be done through a referral from a pediatrician. Specialists capable of providing this diagnosis include developmental pediatricians, psychologists, psychiatrists, and certain early intervention programs​​


Diagnosis Tool Requirements

Specialists use specific tools for evaluating and confirming a child's diagnosis of ASD. Tools like the Autism Diagnosis Interview – Revised (ADI-R) are crucial in this process. These tools help determine the child's official diagnosis, essential for Medicaid authorization​​.


Additional Documentation and Authorization Process

Along with the diagnosis, Georgia Medicaid may request additional documents like the Individualized Family Service Plan (IFSP) or the Individualized Education Plan (IEP). These documents, though not mandatory, are helpful in obtaining authorization for ABA services. Once all necessary information is compiled, it can be submitted by a Medicaid provider to authorize ABA services, typically for 3-6 months and covering 10-30 hours per week based on the BCBA supervisor's recommendation​​.

Conclusion

Georgia Medicaid's coverage of ABA therapy provides essential support for families with children diagnosed with ASD, helping them access critical treatment. Understanding the eligibility criteria, diagnosis process, and authorization requirements is key for families to navigate the system effectively and ensure their children receive the necessary care. Level Ahead ABA is proud to partner with Georgia Medicaid to offer high-quality ABA services, making it easier for families to access the treatment their children need for a brighter future.

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FAQ

Q: Who can diagnose ASD for ABA therapy coverage under Georgia Medicaid?

A: A diagnosis of ASD can be made by developmental pediatricians, psychologists, psychiatrists, or through certain early intervention programs.

Q: What diagnostic tools are required for ABA therapy authorization by Georgia Medicaid?

A: Diagnostic tools such as the Autism Diagnosis Interview – Revised (ADI-R) are typically used for evaluation. These are required for Medicaid authorization.

Contact us today to discuss your insurance coverage options together.


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Insurances We Accept

At Level Ahead ABA, we simplify the insurance process, ensuring you can access our exceptional ABA therapy with peace of mind.

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