Is ABA Therapy Covered by Medicaid?

As of right now, all 50 states have mandates that require some level of insurance coverage for the treatment of autism spectrum disorder (ASD). Applied Behavior Analysis is considered an evidence-based therapy and is NOT considered “experimental.” With respect to Medi-Cal and Medicare, these insurance entities cover all medically necessary behavioral health treatment services for beneficiaries. This typically includes children diagnosed with ASD. Since Applied Behavior Analysis is an evidence-based and effective treatment for individuals with ASD, it is considered a covered treatment when medically necessary. In many cases, private insurance will also cover ABA services when medically necessary; however in these cases, it is best to speak directly with your medical insurance provider to determine the specifics of your family’s coverage (e.g., copays, coinsurance, deductibles, maximums) and to ensure that ABA is in fact, a covered benefit.

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