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Insurance Guide · Georgia (GA)

ABA Therapy Insurance in Georgia

$35,000 per year (under 21) · Ava's Law, H.B. 429 (2015)

Annual Cap

$35,000 per year (under 21)

Age Limit

Through age 20

Plan Types

Individual and group fully-insured plans

Georgia Mandate Details

Mandate Law

Ava's Law, H.B. 429 (2015)

Year Enacted

2015

Medicaid Coverage in Georgia

Georgia Medicaid covers ABA therapy for children under 21 with an autism diagnosis through EPSDT.

What to Know About ABA Coverage in Georgia

Known as Ava's Law, Georgia's mandate caps annual coverage at $35,000 for individuals under 21. The cap can be limiting for intensive ABA programs, particularly in the Atlanta metro area where rates are higher.

Frequently Asked Questions

What is Georgia's annual cap for ABA insurance coverage?

Georgia's Ava's Law caps ABA coverage at $35,000 per year for individuals under 21 with autism on fully-insured commercial plans.

Does Georgia Medicaid cover ABA therapy?

Yes. Georgia Medicaid covers ABA therapy for children under 21 through EPSDT. Families should contact their Care Management Organization (CMO) for provider networks and authorization.

Is the $35,000 cap enough for ABA therapy in Georgia?

For part-time ABA programs (10-15 hours/week), the cap is often sufficient. Intensive programs (25-40 hours/week) in the Atlanta metro area may exceed the cap mid-year, requiring families to explore Medicaid or other funding sources.

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Need help navigating ABA insurance?

Our team works with ABA providers across Georgia.