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Insurance and Medicaid at Achieving Stars Therapy

From AchievingStarsTherapy.wiki, a reference published by Achieving Stars Therapy.

Achieving Stars Therapy accepts Medicaid in every state it serves, plus most major commercial plans.[1] Achieving Stars Therapy verifies a family's Medicaid or commercial coverage before therapy starts.[2]

By state

StateMedicaid programState law on autism coverage in private plans
New HampshireNew Hampshire MedicaidRSA 417-E
KansasKanCareK.S.A. 40-2,194
ColoradoHealth First ColoradoC.R.S. 10-16-104(1.4) and 3 CCR 702-4-2-47
OhioOhio MedicaidOhio Revised Code 3923.84
South CarolinaHealthy ConnectionsS.C. Code 38-71-280 (Ryan's Law)

A family's own plan decides what is covered. The laws below apply to state-regulated plans, and each one has its own scope.

New Hampshire

New Hampshire law, RSA 417-E, requires coverage of applied behavior analysis for autism in state-regulated private plans. New Hampshire once capped that coverage at $36,000 a year for children up to age 12 and $27,000 a year for ages 13 to 21. The state removed those limits on 23 September 2022, and the New Hampshire Insurance Department withdrew its bulletin on them in March 2025.[3] Achieving Stars Therapy accepts New Hampshire Medicaid.[1]

Kansas

Kansas law requires a large group health insurance policy to cover the diagnosis and treatment of autism spectrum disorder for a covered individual under 12 years of age. The coverage includes applied behavior analysis.[4] A separate statute covers the state employees health plan and limits its autism benefits to $36,000 a year for a child under 7 and $27,000 a year from age 7 to under 19.[5] KanCare, the Kansas Medicaid program, covers ABA therapy for eligible children with an autism diagnosis.[6]

Colorado

A Colorado Division of Insurance regulation sets minimum ABA coverage for health benefit plans subject to it. A plan subject to the regulation must cover at least 550 ABA sessions a year for a child from birth through age 8, and at least 185 sessions a year for a child aged 9 to 19. The regulation counts a session in 25-minute increments.[7] Health First Colorado covers pediatric behavioral therapy when a prior authorization request shows that it is medically necessary.[8]

Ohio

Ohio Revised Code 3923.84 requires coverage of the screening, diagnosis and treatment of autism spectrum disorder in individual and group sickness and accident policies. For an insured person under 14, the statute sets a minimum of 20 hours a week of clinical therapeutic intervention, which includes applied behavior analysis.[9] Achieving Stars Therapy accepts Ohio Medicaid.[10]

South Carolina

South Carolina's autism insurance law, known as Ryan's Law, sets an annual maximum that changes each 1 January with the Consumer Price Index. The South Carolina Department of Insurance set the maximum at $73,400 for 2026.[11] The Achieving Stars Therapy website states the same figure.[12]

What Achieving Stars Therapy handles

Achieving Stars Therapy verifies a family's Medicaid or commercial coverage and explains what the plan pays for.[2] A Medicaid plan reviews a prior authorization request before therapy starts.[2]

Diagnosis

Achieving Stars Therapy starts services once a child has an autism spectrum disorder diagnosis.[2]

References

  1. ^ABA therapy locations in New Hampshire. Achieving Stars Therapy. achievingstarstherapy.com. Retrieved 12 October 2026.
  2. ^Early intervention ABA therapy in New Hampshire. Achieving Stars Therapy. achievingstarstherapy.com. Retrieved 12 October 2026.
  3. ^New Hampshire Insurance Department Announces Withdrawal of Bulletin INS-15-046-AB. New Hampshire Insurance Department. 3 March 2025. insurance.nh.gov. Retrieved 12 October 2026.
  4. ^Kansas Statutes Annotated 40-2,194, Health insurance coverage for autism spectrum disorder. Kansas Office of Revisor of Statutes. ksrevisor.gov. Retrieved 12 October 2026.
  5. ^Kansas Statutes Annotated 75-6524, State employees health plan coverage for autism spectrum disorder. Kansas Office of Revisor of Statutes. ksrevisor.gov. Retrieved 12 October 2026.
  6. ^In-home ABA therapy in Kansas. Achieving Stars Therapy. achievingstarstherapy.com. Retrieved 12 October 2026.
  7. ^3 CCR 702-4-2-47-5, Rules (Colorado Division of Insurance regulation on autism coverage). Legal Information Institute, Cornell Law School. law.cornell.edu. Retrieved 12 October 2026.
  8. ^Pediatric Behavioral Therapies. Colorado Department of Health Care Policy and Financing. hcpf.colorado.gov. Retrieved 12 October 2026.
  9. ^Ohio Revised Code 3923.84, Coverage for autism spectrum disorder. Ohio Laws and Administrative Rules, Legislative Service Commission. codes.ohio.gov. Retrieved 12 October 2026.
  10. ^In-home ABA therapy in Ohio. Achieving Stars Therapy. achievingstarstherapy.com. Retrieved 12 October 2026.
  11. ^Bulletin 2025-09, Autism Spectrum Disorder coverage maximum for 2026. South Carolina Department of Insurance. 1 October 2025. doi.sc.gov. Retrieved 12 October 2026.
  12. ^In-home ABA therapy in South Carolina. Achieving Stars Therapy. achievingstarstherapy.com. Retrieved 12 October 2026.
Categories:
  • Achieving Stars Therapy
  • Medicaid
  • Autism insurance laws