Short, sourced answers to the questions families ask us, with the sources behind each one. General information, not advice for your child.
Questions Parents Ask About ABA Therapy
Medicaid and insurance
- Medicaid and insuranceHow do I appeal an ABA denial in Florida?Appeal to your Medicaid health plan within 60 days of the denial notice, by phone or in writing. The plan must decide within 30 days, or 48 hours if expedited. If it upholds any part of the denial, you can ask AHCA for a fair hearing within 120 days. Appealing within 10 days can keep approved services going.Read more →
- Medicaid and insuranceDoes Florida KidCare cover ABA therapy?Partly. KidCare's Medicaid program is Florida Medicaid, which covers medically necessary ABA for eligible children under 21, with prior authorization. Florida Healthy Kids, the KidCare program for ages 5 through 18, does not cover ABA, according to Florida KidCare. For MediKids and the Children's Medical Services Health Plan, ask your child's plan how it handles ABA.Read more →
- Medicaid and insuranceWhat changed with Florida Medicaid ABA in 2025-2026?Since February 1, 2025, Medicaid ABA for children in a managed care plan is paid by that plan instead of the state, and AHCA's current coverage policy took effect February 10, 2025. Prior authorization now goes through the plan, and providers must be in its network. In 2026, the Legislature created a task force to review the program.Read more →
- Medicaid and insuranceWill Florida limit Medicaid ABA? What is the ABA task force?Not yet. As of October 21, 2026, Florida has not adopted any new limit or cap on Medicaid ABA. A 10-member task force created by the Legislature is studying limits on how long services are authorized and possible caps on months of ABA. Its recommendations are due to the Governor and legislative leaders by December 31, 2026.Read more →
- Medicaid and insuranceMy child lost Medicaid ABA or had hours cut: what can I do?If your child's Medicaid plan denied, cut or stopped ABA, you can appeal to the plan within 60 days of the notice; appealing within 10 days can keep approved hours going. If DCF ended the Medicaid, appeal within 10 days of DCF's letter. If your agency left the plan, ask the plan for another in-network provider.Read more →
- Medicaid and insuranceWhat does Medicaid need to approve ABA therapy in Florida?For a child under 21, Florida Medicaid needs a referral with a doctor's order, a comprehensive diagnostic evaluation led by a licensed practitioner, a behavior assessment with standardized test scores (the Vineland-3 and, for ages 2 to 18, the BASC-3 PRQ), a behavior plan, and prior authorization. Renewal needs a reassessment at least every six months.Read more →
- Medicaid and insuranceIs Sunshine Health ABA paused?No. Sunshine Health says ABA is covered for its Medicaid members when it is medically necessary and approved in advance. What it paused, starting October 1, 2025, was adding new practitioners to existing ABA provider groups. It ended that pause in Regions E and F on March 1, 2026, but has announced no end for Palm Beach County (Region G).Read more →
- Medicaid and insuranceCan I switch ABA providers without losing Medicaid hours?Yes, you can switch, but the new agency needs its own prior authorization, so your Medicaid plan decides the hours again. Sunshine Health, for example, requires a new authorization and a Change of Provider form. Start the paperwork before you leave your current agency, and confirm the new one is in your plan's network.Read more →
Talk to a real person about your child
Free consultation. We'll call you within one business day, usually the same day.