Your path to ABA in Florida
A plain list of the steps between a first worry and the first ABA session. Every family's order is a little different, and some steps overlap. For each one: what happens, what to ask for, and where to read more.
- Step 1 / 8
Talk to your child's pediatrician
- What happens
- You tell the doctor what you have noticed. The pediatrician can look at your child's development, listen to your concerns and decide on next steps. You don't have to wait for a scheduled visit if you are worried.
- What to ask for
- Ask for a developmental screening and, if you still have concerns afterward, for a referral for a full evaluation. If the doctor says to wait but you are still worried, it is fine to ask again or to get a second opinion.
- Step 2 / 8
Developmental screening
- What happens
- A screening is a short questionnaire or check that shows whether a child should be looked at more closely. It is not a diagnosis. Public programs can also screen: Florida Early Steps for children under 3, and FDLRS Child Find with your school district for ages 3 to 5.
- What to ask for
- Ask which screening tool is used and what happens next if the result raises a concern. Ask whether a referral for evaluation is recommended.
- Step 3 / 8
Diagnostic evaluation
- What happens
- A qualified professional (for example a developmental pediatrician, a child neurologist, a child psychologist or another licensed practitioner) evaluates your child and writes a report with findings and recommendations. For Florida Medicaid ABA, the report must be a comprehensive diagnostic evaluation.
- What to ask for
- Ask the office how to book, whether they take your child's insurance, and what the report will include. Ask your plan or your ABA provider whether that report meets what they need.
- Step 4 / 8
The doctor's referral or prescription for ABA
- What happens
- A physician or another qualified practitioner, such as a child psychologist, writes the referral for ABA. For Florida Medicaid, the referral must include a physician's order for behavior analysis services and the comprehensive diagnostic evaluation.
- What to ask for
- Ask the doctor for the written referral or order for ABA and a copy of the evaluation report to give to your ABA provider.
- Step 5 / 8
Insurance or Medicaid authorization
- What happens
- ABA services usually need prior authorization, and Florida Medicaid always requires it. The provider sends the request to your child's insurance or Medicaid plan, and the plan decides whether the services are medically necessary. The request for therapy includes the BCBA's assessment and treatment plan (the next two steps), so these steps overlap. Each plan can have its own forms.
- What to ask for
- Ask your plan, or your provider, what documents they need, whether your provider is in network, and what to do if the request is denied. If it is denied, you can appeal.
With Paramount Behavior: We check your benefits for free, usually the same day. We start the paperwork with you from the first call.
- Step 6 / 8
ABA assessment by a BCBA
- What happens
- A Board Certified Behavior Analyst (BCBA) meets your family, interviews you, observes your child and uses standardized tools to learn your child's strengths and needs. This is where your child's goals begin.
- What to ask for
- Ask who will do the assessment, where it happens, which tools are used, and how your family's priorities will be included.
With Paramount Behavior: We have no waitlist: there are openings, and we book the free initial consultation as soon as you call. What usually sets the pace after that is the paperwork (the doctor's order, the diagnostic evaluation and the insurance or Medicaid authorization) and your family's schedule.
- Step 7 / 8
Treatment plan and sessions
- What happens
- The BCBA writes a treatment plan with goals, strategies and how progress will be reported, and you review it with the BCBA. When the plan is authorized, sessions begin, usually delivered by a Registered Behavior Technician (RBT) supervised by the BCBA.
- What to ask for
- Ask to read the plan before you sign. Ask how goals were chosen, who supervises the sessions, and how you will be trained to use the same strategies at home.
- Step 8 / 8
Ongoing reviews
- What happens
- The plan is reviewed and updated on a regular schedule set by your plan, with new assessments and progress data. Hours or approvals can change at renewal. You can also change providers if the fit is not right.
- What to ask for
- Ask when the next review is, what data you will see, and what to do if hours are cut or you want to switch providers.
General information for parents, not medical, legal or coverage advice for your child.
Common questions
Do I need a diagnosis to start ABA in Florida?
For Florida Medicaid, yes: it requires a doctor's written order and a comprehensive diagnostic evaluation. Private plans vary, so ask your plan what it requires.
Can I call an ABA provider before I have the evaluation?
Yes. You can ask questions at any stage, and a provider can tell you which papers your plan will need. Paramount Behavior books the free consultation as soon as you call.
What if my child's request is denied?
A denial is not always the end. You can usually appeal, and our appeals page explains how it works for Florida Medicaid.
Sources
- Florida Medicaid Behavior Analysis Services Coverage Policy. Agency for Health Care Administration (AHCA).
- Behavior Analysis Services information. Agency for Health Care Administration (AHCA).
- Florida Early Steps. Florida Department of Health.
- FDLRS Child Find. Florida Diagnostic & Learning Resources System.
- Clinical testing and diagnosis for autism spectrum disorder. Centers for Disease Control and Prevention.
Talk to a real person about your child
Free consultation, booked as soon as you call. No waitlist. We also check your benefits for free, usually the same day.