At-Home ABA Therapy In Georgia

Georgia is geographically big and demographically split. Atlanta and its near-suburbs operate like a major metro. Drive 90 minutes in any direction and the landscape changes — fewer providers, longer drives to a pediatric specialist, county seats serving as the only real service hub for a 50-mile radius.

Our Mastermind Behavior in-home ABA therapy model is built for exactly that. A Board Certified Behavior Analyst completes the assessment in your home, watches what happens in actual settings (the carpool drop-off meltdown, the iPad transition, the way bedtime falls apart), and a Behavior Technician runs direct sessions in your house — usually 10 to 30 hours a week, with weekly BCBA supervision and parent training built in.

The diagnosis. Under Ava's Law the diagnosis has to come from a licensed physician or licensed psychologist, and the plan must cover the assessments and tests used to make it. A school evaluation or a screening tool is not enough on its own to unlock the benefit.

Medical necessity, and who decides it. Since SB 118 took effect in January 2019, it is the covering entity, your insurer, that determines whether ABA is medically necessary, and it may ask a licensed physician or psychologist to demonstrate ongoing medical necessity at least once a year. That annual redetermination is why treatment plans in Georgia are written with measurable goals and reviewed on a schedule, and why we keep the data that supports them.

If your child is on Georgia Medicaid. Prior authorization is required for every Medicaid-covered ABA service, without exception, and it is issued in six-month increments. The assessment and the treatment plan each need their own authorization, and both must be requested by the enrolled qualified provider. Services delivered without a current authorization are not covered, so timing matters: we start the reauthorization well before the six months run out.

If your plan says no. Georgia's independent review process only opens once the plan's own grievance process has been exhausted, and the deadline for starting that internal grievance is set by the plan, so use the date printed on the denial letter and file promptly. Independent review requests then go to the Georgia Office of the Commissioner of Insurance and Safety Fire, which took over the program from the Department of Community Health in July 2022. A standard review is decided within 15 working days of the record being complete; an expedited review, where a delay would harm your child, within 72 hours. Self-funded employer plans sit outside this process and use the federal external review route instead.