ABA Therapy Insurance Coverage with Peach State Health Plan

We Handle the Insurance, So You Can Focus on Your Child

If your family is covered by Peach State Health Plan, we’re here to make the process as easy as possible. ‍

We work directly with Peach State Health Plan to handle all the paperwork, verify your coverage, and get your child into therapy quickly—so you can focus on your child’s progress and not on the insurance details.

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What’s Covered Under Peach State Health Plan for ABA Therapy

Here’s what you can expect when using Peach State Health Plan for ABA therapy. Coverage generally includes:

Comprehensive Behavioral Assessments
‍We confirm your benefits before therapy starts, so you’ll know exactly what’s covered and what to expect.

In-Home ABA Therapy
‍One-on-one therapy in the comfort of your home where your child feels most at ease. This is where ABA therapy happens most effectively, addressing communication, behavior, and life skills.

School-Based Support
‍Therapy that extends into your child’s school environment, ensuring the skills they learn at home carry over into the classroom and social settings.

Parent Training & Support
‍We equip you with the knowledge and skills to continue reinforcing therapy at home, ensuring your child’s progress is consistent and long-lasting.

Ongoing Monitoring & Adjustments
‍Regular tracking of your child’s progress with ongoing adjustments to the therapy plan to ensure continuous improvement.

Peach State Health Plan’s ABA Therapy Coverage: Key Insights

Eligibility and Coverage

Peach State (Georgia Medicaid) covers ABA therapy for children under age 21 diagnosed with ASD, as part of the Early & Periodic Screening, Diagnostic & Treatment (EPSDT) benefit.

Pre-authorization and Diagnosis

To access ABA services, children must have a formal ASD diagnosis and meet medical necessity criteria. Pre-authorization is also required.

Coverage for Therapy Sessions

Peach State covers a variety of ABA services, including in-home and school-based therapy. The number of therapy hours may vary based on the child’s needs.

Provider Requirements

Services must be provided by a Peach State-enrolled provider, who is qualified to deliver ABA services under Medicaid.

How Milestone Achievements Works with Your Peach State Health Plan Plan

At Milestone Achievements, we simplify the process with Peach State Health Plan. Here’s how we do it:

Reach Out to Us
Provide us with your Peach State Health Plan plan details and child’s diagnosis, and we’ll start the verification process right away.

We Verify Your Benefits
We’ll contact Peach State Health Plan to confirm your benefits and check what ABA therapy services are covered, including in-home therapy, school support, and any pre-authorization requirements.

We Handle the Paperwork
Forget about spending time on hold with customer service reps. We’ll take care of all the forms and submissions to Peach State Health Plan, so you don’t have to.

Therapy Begins
Once your coverage is confirmed, we schedule your child’s first therapy session in your home, on your schedule.

Start the Process Today

Why Families Trust Milestone Achievements with Peach State Health Plan

Here’s why families working with Peach State Health Plan choose Milestone Achievements for their child’s ABA therapy:

No Surprises - We confirm your benefits before therapy starts, so you’ll know exactly what’s covered and what to expect.

We Handle the Details - We take care of all the paperwork, authorization, and claims submissions. No stress, no extra work for you.

Therapy in Your Home - ABA therapy that’s personalized to your child’s needs, delivered right where they’re most comfortable—in your home.

Frequently Asked Questions About Peach State Health Plan Coverage

Who qualifies for ABA/ABS services under Peach State?

Children under age 21 who are Peach State Medicaid beneficiaries, have a documented diagnosis of ASD, and whose care plan meets established medical necessity criteria are eligible.

How many therapy hours does Peach State cover each week?

Coverage depends on individual needs. Some children may qualify for 40 hours per week of ABA therapy under Peach State Medicaid, with adjustments based on the child’s care plan.

What documentation is needed to get approved for ABA therapy under Peach State?

A formal ASD diagnosis, a treatment plan, and proof of medical necessity are required for ABA therapy approval under Peach State Medicaid.

Can a family choose any provider for ABA therapy?

The provider must be enrolled in Peach State Medicaid. Only qualified, credentialed providers will be reimbursed for ABA therapy.

What if Peach State denies coverage for ABA therapy?

You can appeal the decision, providing additional medical documentation or alternative treatment justifications.

Does Peach State Medicaid cover out-of-pocket expenses for ABA therapy?

Generally, Peach State Medicaid covers ABA therapy without requiring co-pays or deductibles, but some families may have small incidental costs.

How long does it take to get approval for ABA therapy under Peach State?

It typically takes 2–4 weeks for approval, though urgent requests may be expedited depending on provider and treatment urgency.

Let’s Get You Covered

Insurance should never be a barrier to your child’s progress. Milestone Achievements works directly with Peach State Health Plan to ensure your child gets the therapy they need—without the confusion or delays. Let us handle the insurance details so you can focus on your child’s growth.