CareFirst coverage for ABA, verified before your child's first session.
CareFirst BlueCross BlueShield is Maryland's own Blue Cross Blue Shield plan, and Terrapin ABA is in-network with CareFirst. Care starts with a free verification of your exact benefits, plain answers about costs, and every authorization handled by our team.
Does CareFirst cover ABA therapy in Maryland?
For most members, yes, and Terrapin ABA is in-network with CareFirst. CareFirst BlueCross BlueShield is Maryland's Blue Cross Blue Shield plan, and many of its plans are written under Maryland rules. That matters because of the state's habilitative services mandate: plans regulated by Maryland must include habilitative benefits for children, ABA among them for a child with an autism diagnosis, until at least the end of the month the child turns 19. A CareFirst plan purchased on Maryland's individual marketplace, or through an employer with a fully insured plan, generally carries that benefit.
The one setup we always check for is self-funded employer coverage, where the employer pays claims itself and uses CareFirst to administer the plan. Benefits like that follow federal law and are written by the employer, and while many still include ABA, the details vary. Rather than asking you to decipher plan documents, we contact CareFirst, pull your exact benefits, and give you a precise picture of what your plan covers before anything begins. And because we are in-network, your claims process under your plan's in-network terms, billed by us directly to CareFirst.
- In-network with CareFirst, and your exact benefits checked for free
- State-regulated Maryland plans must cover ABA for children with autism
- Deductibles, copays, and authorization steps translated for you
We carry the paperwork from first call to renewal.
Free benefits check
Share the member ID on your CareFirst card and a few basics about your child. We contact CareFirst, confirm the ABA benefit, and call you back with plain answers.
Authorization request
CareFirst plans generally require approval before therapy starts. We assemble the diagnosis records and request authorization for the initial assessment, which appears on statements as CPT 97151.
Direct session billing
Claims travel from us to CareFirst without a detour through your kitchen table. Statements typically show 97153 for one-on-one therapy hours, 97155 for the BCBA's oversight of the treatment plan, and 97156 for caregiver training.
The six-month renewal
ABA authorizations run on six-month cycles. We keep the renewal calendar, collect progress data well before each deadline, and file on time so an expiring authorization never blindsides your family.
What CareFirst members ask us.
Start with the answer, not the paperwork.
Send us the basics from your CareFirst card. We verify your benefits at no cost, walk you through what we found, and answer every question. You decide what happens next.