For a lot of East Bay families, the hardest part of starting ABA isn't the therapy — it's the paperwork. Authorizations, medical-necessity language, prior-auth timelines: it's a lot to take on while you're also caring for your child. Below is a plain walk-through of how ABA gets authorized and funded, and what we handle for you.
Under California law (SB 946, in effect since 2012), state-regulated health plans must cover medically necessary behavioral health treatment for autism, including ABA. If your child has an autism diagnosis and your plan is through Kaiser or CCHP, you're very likely entitled to coverage. The question is usually how to access it, not whether you can.
Funders authorize ABA when it's medically necessary, meaning there's a documented autism diagnosis and a clinical assessment showing that ABA is an appropriate treatment for your child's needs. You don't have to prove this yourself. A BCBA's assessment is what establishes medical necessity, and we write it in the language funders expect.
A note for Medi-Cal families: CCHP is Contra Costa's Medi-Cal managed care plan, and we bill CCHP directly — so if your child's Medi-Cal runs through CCHP, we're in-network. We don't currently bill other Medi-Cal plans directly, though some RCEB clients are Medi-Cal eligible through a separate pathway. Have a different plan? Ask us about a single-case agreement; it can sometimes let us work with families whose plan we're not normally in-network with.
Throughout, the paperwork sits on our side of the desk. We submit the assessment and reports your funder requires, track deadlines so services don't lapse, and keep you posted at each step.
You don't need everything ready to reach out, but these speed things up once we begin:
For Kaiser and CCHP families, once authorization is in place, our small caseloads mean sessions typically start within a month. End to end from first contact, plan for four to eight weeks, sometimes faster. RCEB cases vary. Delays usually come from missing documentation or funder review times, not from the therapy itself. That's why we stay on top of the paperwork and advocate on your behalf if an authorization stalls.
For in-network clients, your standard plan copays apply. We never ask families to pay out of pocket for services your plan covers, and we'll help you confirm your exact cost-share before services begin.
A denial isn't the end of the road. Plans have appeal processes, and a denial is often about a missing form or unclear documentation rather than a true "no." If it happens, we help you understand why and what comes next.
Not sure where your plan stands? Send us your information and we'll help you find out: call (510) 500-5124 or fill out our intake form. A clinician reviews every request personally.
This article is general information, not legal, medical, or insurance advice. Coverage depends on your specific plan and eligibility.
