Autism and Applied Behavior Analysis (ABA) therapy

Overview

Apple Health for Kids coverage offers Applied Behavior Analysis (ABA) therapy as a benefit for children diagnosed with Autism Spectrum Disorder (ASD). Other services, such as physical therapy, speech therapy, and occupational therapy are also covered services a childre with autism may receive.

Eligibility and acceptance

In order for a child or youth to be eligible for ABA therapy through Apple Health/Medicaid, a recognized Centers of Excellence (COE) must conduct a comprehensive evaluation, and write an order for Applied Behavior Analysis therapy.

If the COE determines that the child meets medical necessity for ABA services, they will provide the family with a copy of their comprehensive evaluation, recommendations, and order for ABA treatment. The family is encouraged to contact all of the Medicaid-enrolled ABA providers in their area to be added to the waiting lists. ABA providers require a copy of the COE evaluation and order to ensure clients have completed phase one of the ABA pathway to care.