Advocacy Corner

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Dec 16, 2025
4 min read

Updated: Dec 22, 2025

Evaluations are at risk: Fighting for Fair Medicaid Rates for Autism Evaluations in Colorado

By Dr. Lila Kimel

November 17, 2025

The following blog reflects some of the work that Dr. Kimel and other psychologists in Denver have been advocating for our community to continue to be able to accept Medicaid for autism evaluations. Please note that this material comes from work done by Dr. Lila Kimel, Dr. Lisa Griffiths, and Dr. Jennifer Paz Ryan, along with advocacy work by Andy Rose, LPC.

Families across Colorado know how important it is for children to get proper autism evaluations. These evaluations are the first step to understanding a child’s needs and getting the right support at school, at home, and in therapy. But right now, these critical services are at risk because of changes being considered to Medicaid rates for psychological testing.

What’s Happening?

Medicaid is the government program that helps many families pay for healthcare. In Colorado, many children who need autism evaluations rely on Medicaid. Some policymakers are thinking about lowering the rates they pay psychologists for these evaluations, even though these assessments take many hours of specialized work, and the cost of living in Colorado is high.

If these rates go down, fewer psychologists will be able to offer evaluations to Medicaid families. This is especially concerning for families who speak Spanish or other languages because there are already very few bilingual psychologists providing these services.

Why This Matters

Right now:

Many families are waiting over two years for an evaluation.
Cutting rates will likely force small practices to close.
Children from Black, Latino, and immigrant families will be affected the most because these communities already face more barriers to care.

Kimel Psychological Services is one of only a few practices in Colorado that specializes in autism and developmental disability evaluations. We often help with extra testing for Children’s Hospital of Colorado.

Our team of seven psychologists: including three who speak Spanish, completes about 40–45 evaluations each month.

If Medicaid rates drop to 85% of current Medicare benchmarks:

Our clinicians, after paying overhead, would only take home $35–$40 per hour.
Comprehensive autism evaluations, which take 12–20+ hours and cost $250–$300 in non-reimbursable materials, would be impossible to sustain.
Many practices, like ours, would have to stop offering these services, leaving thousands of children without access.

Recent closures, such as Wellpower’s assessment department in June 2025, show how fragile access already is. Reducing rates will widen the gap in services, increase wait times, and may even cost the state more in the long run if families must redo expired evaluations.

Why This Is Advocacy

Advocacy means speaking up for what’s fair and necessary. Psychologists like Dr. Kimel are actively writing letters, giving testimony, and sharing data to make sure families in Colorado, especially those in underserved communities—don’t lose access to autism evaluations.

We are asking policymakers to:

Reject cuts to Medicaid rates for psychological testing.
Ensure fair payment for all hours worked with add-on code parity.
Provide extra support for bilingual evaluations, so children who speak languages other than English can get timely, high-quality assessments.
Maintain sustainable reimbursement structures to protect patient access and clinician workforce while reducing long-term costs to the system.

Why This Matters for Families

Small private practices like ours don’t work with Medicaid to make money. We do it because we care about giving every child access to care, no matter their background or language. With fair rates, we can continue helping children get the diagnoses, treatments, and supports they need to thrive.

The decisions made now will affect thousands of children and families. Supporting fair Medicaid rates ensures every child in Colorado has a chance to get the help they deserve.

Psychotherapy is At Risk: Protecting Access to Mental Health Care for Colorado Families

I want to share some very important news about Medicaid mental health services in Colorado and why it matters for families, children, and the communities we serve.

At Kimel Psychological Services, we provide specialized therapy and evaluations for children and adults with developmental disabilities, including autism. Many of our patients rely on Medicaid, and some of our services are offered in Spanish, which is rare in our area.

Over the past few years, our clinic worked hard to become an Essential Safety Net Provider (ESNP) for Medicaid. This meant investing nights, weekends, and even valuable family vacation time to meet strict state requirements. Our staff went through extensive training, fingerprinting, and audits to ensure compliance. All of this effort helped us deliver high-quality care to Colorado’s most vulnerable families.

Recently, we received alarming news from CCHA/Anthem:

Medicaid reimbursement rates for outpatient mental health services were cut by 34%.
Our ESNP status was revoked.

These changes put our small clinic, and the families we serve, at serious risk. High-quality mental health care, especially for children with autism or other developmental disabilities, takes time, resources, and highly trained providers. Cutting reimbursement rates makes it nearly impossible to keep experienced staff and maintain services.

This is not just a financial issue. These decisions were made without warning or discussion, undermining trust between providers and managed care organizations. Families who rely on timely therapy for their children will feel the impact immediately, particularly those who face language barriers or other challenges.

What we need help advocating for:

Restore fair and sustainable reimbursement rates for mental health services.
Make ESNP status transparent and equitable, so clinics can continue providing essential care.
Ensure rules protect providers from sudden, unilateral cuts by for-profit insurance companies.
Create clear accountability to maintain minimum service rates.

Colorado’s mental health system is already stretched thin. These changes threaten access to care for the children and families who need it most. We are calling on lawmakers, advocates, families we serve, and the public to take action now to protect these vital services.

Together, we can make sure families continue to get the care they need and deserve.

Note: Dr. Kimel was recently featured on Channel 9 News, discussing these matters. She is a member of COMBINE, an advocacy group dedicated to promoting equitable access to healthcare, social services, and community resources for underserved populations. It works to influence policy, raise public awareness, and empower individuals and families to navigate complex systems effectively.