Pediatric Behavioral Therapies (Health First Colorado)
Colorado · Colorado Department of Health Care Policy and Financing (HCPF), part of the EPSDT benefit
Our summary
Pediatric Behavioral Therapies is a Health First Colorado (Medicaid) benefit for children when the service is medically necessary. An autism diagnosis is not required, and each therapy needs approval before it starts.
- No autism diagnosis needed
What happens after you knock
- A contracted Medicaid provider assesses the child and writes a treatment plan.
- The provider sends a Prior Authorization Request (PAR) for a medical necessity review before treatment starts.
- Each approved PAR lasts up to six months.
No answer?
Email HCPF_EPSDT@state.co.us.
Family Voices Colorado helps families with public or private health insurance: 303-877-1747.
If the answer is no
Family Voices Colorado teaches about private and public insurance appeals: 303-877-1747.
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Family Voices ColoradoFamily Voices Colorado helps families with public or private health insurance.In their words7 quotes ›
“Does my child have to have a diagnosis of Autism to qualify for the services?”hcpf.colorado.gov
“No. Behavioral therapy is available to all children currently eligible for Health First Colorado when the service is medically necessary.”hcpf.colorado.gov
“All behavioral therapies will need to be authorized prior to the start of treatment.”hcpf.colorado.gov
“The contracted Medicaid provider will assess your child, put together a treatment plan, and submit a Prior Authorization Request (PAR) to the Department's Utilization Management (UM) vendor to review for medical necessity.”hcpf.colorado.gov
“Yes. All EPSDT services are available to all children receiving Health First Colorado.”hcpf.colorado.gov
“If your child is not eligible for Health First Colorado due to income, you could potentially access Health First Colorado under the Children's Buy In Program.”hcpf.colorado.gov
“Mental/Behavioral Health Care (excludes Pediatric Behavioral Therapy, PBT)”hcpf.colorado.gov
Checked Nov 1, 2026 against hcpf.colorado.gov. Something changed? Tell us