As of Wednesday, March 18, HCA’s lobby will be closed. In-person customer services for Apple Health and the PEBB and SEBB Programs will not be available. Learn more.
Autism and Applied Behavior Analysis (ABA) therapy
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 children with autism may receive.
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.
Participation in ABA services does not preclude other therapies such as, speech therapy, occupational therapy, and physical therapy depending on the individual child's needs. It is most essential that treatment providers coordinate and collaborate with one another to maximize resources and ensure positive results for the child.
- What to do while waiting for an Autism Center appointment (Seattle Children's Autism Center)
- Washington Autism Alliance and Advocacy (workshops for parents on ABA waiting lists)
- ABA day program capacity attestation form (13-0007)
- ABA attestation form (13-0008)
- Centers of Excellence (COE) attestation form (13-0009)
- ABA level of support requirement form (12-411) Word | PDF
- ABA Assessment and Behavior Change Plan (13-400)
- General Information for Authorization form (13-835) Word | PDF (Instructions)
- Autism Spectrum Disorder (ASD) facts (CDC)
- Speech, language and hearing services for children