It is important to find the right provider of services to support a child with autism. Many parents also want to know whether the therapy center accepts Medicaid coverage once they’ve selected a good center. Insurance coverage is a major factor in the affordability of ABA therapy in Maryland, in that it may require multiple sessions per week.

Fortunately, several Maryland ABA centers accept Maryland Medicaid or can work with Maryland Medicaid managed care plans. However, coverage may differ from plan to plan and location to location, and may require prior authorization. Familiarizing yourself with the Medicaid process can help make it easier and get your child the care they need.

Does Maryland Medicaid Cover ABA Therapy?

Yes. Medically necessary ABA therapy is covered by Maryland Medicaid for eligible children with a diagnosis of Autism Spectrum Disorder (ASD). Typically, these services include behavioral assessments, individualized treatment plans, one-on-one therapy, supervision from a Board Certified Behavior Analyst (BCBA), and parent/caregiver training.

Most providers assist families in obtaining prior authorization before treatment to determine eligibility and obtain services.

ABA Centers in Maryland That May Accept Medicaid

Several agencies offering ABA therapy in Maryland collaborate with Medicaid or some Medicaid managed care organizations. Because insurance contract rules are subject to change, it’s always best to check with the insurance provider directly to confirm participation.

The following are some well-known ABA therapy providers in Maryland:

1. Wonder Star ABA
2. Verbal Beginnings
3. Ally Behavior Centers
4. Little Leaves Behavioral Services
5. Centria Autism
6. Butterfly Effects
7. Behavioral Framework
8. The Shafer Center
9. Acorn Health

Some of these organizations accept Medicaid in some areas or are involved with specific Medicaid managed care plans. Some will take private insurance only. Be sure to check your coverage before scheduling an evaluation.

Questions to Ask an ABA Center

Before choosing a provider, inquire about insurance and therapy.

Helpful questions include:

• Do you currently accept Maryland Medicaid?
• What Medicaid managed care plans are you connected with?
• Will you be able to help with obtaining prior authorization?
• Does the school have a waiting list?
• What is the earliest time that therapy can start?
• Do you work in a clinic or in a home setting?
• Do parent training sessions include?

If you have questions, you can avoid unpleasant surprises and find out what to expect.

How to Find an ABA Center That Accepts Medicaid?

First, check with your Medicaid managed care agency for a list of providers that accept your specific Medicaid plan and offer ABA services. Your child’s pediatrician or developmental specialist might also refer your child to a therapy center that typically serves Medicaid families.

Additionally, check providers’ websites; many will list accepted insurance plans and provide information about their enrollment process. When the information is unclear, it may be best to call the billing department for the most accurate answer.

What to Expect During the Enrollment Process?

After selecting an ABA provider, there are several steps to take before therapy begins.

Most centers will begin by scheduling a meeting with your child to gather information about your child’s developmental history and current needs. A BCBA then draws up an extensive behavioral evaluation and formulates a personalized treatment plan.

The provider typically submits this plan to Medicaid for approval. After permission has been granted, therapy can commence as recommended and outlined in the schedule.

The application process could take several weeks, but most providers will guide the family through it and keep them informed as they go.

Choosing the Right ABA Provider

While insurance is crucial, it shouldn’t be the sole consideration when deciding on an ABA center.

Try to find providers that provide:

• Board Certified Behavior Analysts (BCBAs)
• Individualized treatment plans
• Regular progress reviews
• Involving parents in the education of their children and providing them with training.
• Regular, effective lines of communication with parents/ careers.
• Flexible scheduling
• Positive reviews and experience working with children with autism

A provider who supports families during therapy sessions and at home can facilitate consistent progress for children in both settings.

Understanding Waiting Lists

Maryland ABA therapy has become in demand across Maryland – some providers even have waiting lists! Waiting time will vary based on location, staffing availability, and your child’s recommended therapy schedule.

If the wait time is long with one provider, check with your Medicaid plan for other in-network providers. Your child can also be placed on several waiting lists, which can help to get them started on services sooner.

Preparing for Your First Appointment

Before your first visit, you must have some documents ready, including:

• Your child’s Medicaid information
• Reports & documentation of autism diagnosis or evaluation.
• Previous therapy records
• Medical history
• Send out referral forms (if necessary)

These records will be important and may speed up the intake process and start the treatment planning process sooner.

Final Thoughts

Several ABA centers in Maryland accept Medicaid, meaning that therapy will be more accessible for families who want assistance for their child with autism. Insurance coverage and provider participation may change, so please contact the insurance managed care plan and the ABA center to verify coverage before scheduling services.

There’s more to choosing a provider than insurance. Seek out a therapist with proven experience, tailored treatment plans, family engagement, and effective communication in their therapy sessions. When provided by the right provider and with Medicaid coverage, families can access high-quality ABA services that help their child communicate, learn, and grow in the future.