Colorado PBT Reimbursement
Proposed FY 2025-2026 Budget
Summary and Resources
SUMMARY
The proposed Colorado state budget for FY 2025-26 (the proposed 2025 budget) includes a significant decrease in Medicaid reimbursement for ABA services.
This decrease will likely limit access to ABA services for Colorado children who are diagnosed with ASD. Without sufficient access to medically necessary ABA services, Colorado’s pediatric ASD patients may suffer material delays and interruptions in care which will likely result in clinical regression with long-term implications for patients and families.
There is an opportunity for parents, family members, and providers to reach out to their local state legislators to ask them to make sure the decrease is not included in the final 2025 budget.
CALL TO ACTION
Parents, family members, and providers should contact their local legislators (call, email, or letters) to let them know they do not support a decrease in Medicaid reimbursement for ABA services.
Specifically, please share your story with legislators so they know how important this issue is to Colorado families affected by ASD.
● Did you have difficulty finding an ABA provider for your child?
● Did your child have to wait until your ABA provider had an opening? If so, how long?
● Please share the positive impact of ABA on your child or your family.
● Are you seeing improvements in your child? Are you concerned that potentially losing access to ABA services will have a negative impact on those gains?
● Has ABA treatment improved the patient/family’s quality of life?
● You do not support the cut in Medicaid reimbursement for ABA services included in the proposed 2025 budget.
● You support the 2024 reimbursement increase for ABA services that was passed by the Colorado legislature and signed into law by the Governor.
● The 2024 increase must be maintained to ensure your family, and other Colorado families affected by ASD continue to have access to ABA services.
IN-PERSON & VIRTUAL CALL TO ACTION AT THE CAPITAL
● January 6th, 2024 ○ 09:00 a – 05:00 pm
○ Joint Budget Committee (JBC) Hearing Room, 3rd Floor Legislative Service Building
○ 200 East 14th Avenue Denver, CO 80203
○ Link to proposed agenda ○ Link to join virtually
● Voice your support that the 2024 increase for reimbursement for ABA services must be maintained.
● Come and voice your opinion that you do not support cuts in Medicaid reimbursement rates for ABA services in the proposed 2025 budget.
● Ask the JBC to act to ensure your family, and other Colorado families continue to have access to medically necessary ABA services.
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BACKGROUND
● In 2022 and 2023, ABA providers began leaving Colorado due to low ABA Medicaid reimbursement rates.1 As a result, Colorado patients and families lacked sufficient access to ABA services.
● In 2023, an independent committee reviewed Colorado ABA Medicaid reimbursement rates and determined that the Colorado ABA Medicaid rates were 20% below a benchmark based on the average of 10 other states’ rates.2 The committee recommended that Colorado Medicaid increase ABA reimbursement rates to meet the benchmark.
● Also, in 2023 parents, family members, and providers began contacting their legislators asking them to support the committee’s recommendation.
● Thanks to the advocacy efforts, the Colorado legislature’s Joint Budget Committee (the JBC) voted to increase ABA Medicaid rates to meet the benchmark.3 The JBC’s increase was made effective July 1, 2024.
● After the increase, the ABA providers that remained in Colorado made investments to preserve and expand access to ABA services for Colorado families.4
● The Governor’s proposed 2025-26 budget includes a decrease in Medicaid reimbursement for ABA services. On November 1, 2024, Governor Polis presented his proposed budget for 2025-26 that rolled back the JBC’s 2024 increase5, reinstating rates that previously forced providers to leave the state and limited access to life-changing care for Colorado families.
