Does PeachState Cover ABA Therapy?

What is PeachState?

PeachState is a Medicaid provider in Georgia that offers health insurance coverage to eligible individuals and families.

The company is committed to providing affordable and quality healthcare to its members. PeachState offers a range of health services, including medical, dental, and behavioral health services.

Does PeachState Cover ABA Therapy?

The answer is yes, PeachState does cover ABA therapy for children with ASD. However, there are certain criteria that must be met in order to qualify for coverage. PeachState follows the guidelines set forth by the Georgia Department of Community Health (DCH) for ABA therapy coverage.

To qualify for ABA therapy coverage, the child must have a diagnosis of ASD and meet the following criteria:

• The child must be under the age of 21
• The child must have a prescription for ABA therapy from a licensed healthcare provider
• The ABA therapy must be provided by a licensed and qualified provider
• The ABA therapy must be medically necessary and prescribed by a licensed healthcare provider

What Does PeachState Cover?

PeachState covers up to 40 hours of ABA therapy per week for children with ASD. The therapy must be provided by a licensed and qualified provider who is approved by PeachState. The company also covers other behavioral health services, such as counseling and therapy for mental health conditions.

How to Get ABA Therapy Coverage from PeachState

To get ABA therapy coverage from PeachState, you must first ensure that your child meets the criteria for coverage. You will need to provide documentation of your child's ASD diagnosis and a prescription for ABA therapy from a licensed healthcare provider. You will also need to find a licensed and qualified provider who is approved by PeachState to provide ABA therapy.

Once you have all the necessary documentation and have found a qualified provider, you can contact PeachState to begin the process of getting ABA therapy coverage. The company will review your documentation and determine if your child qualifies for coverage.

Summary

In conclusion, PeachState does cover ABA therapy for children with ASD. However, there are certain criteria that must be met in order to qualify for coverage.

If you believe your child may benefit from ABA therapy, it is important to speak with a licensed healthcare provider and contact PeachState to determine if your child qualifies for coverage.

With the right documentation and a qualified provider, your child can receive the ABA therapy they need to improve their quality of life.