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Michigan Medicaid Approved to Provide Applied Behavior Analysis Therapy for Children with Autism

As of April 1, Michigan will begin providing coverage for applied behavior analysis (ABA) services for young children with autism spectrum disorders (ASD) through the Medicaid and MIChild Programs.

The Michigan Department of Community Health (MDCH) recently received federal approval from the Centers for Medicare and Medicaid Services (CMS) to provide ABA services for children ages 18 months through age 5 with an ASD diagnosis of autistic disorder, Asperger’s disorder or pervasive developmental disorder-not otherwise specified.  ABA is an evidenced-based treatment that research has shown can make a difference for children with ASD in improving behavior, communication and social skills, particularly if this intensive intervention is provided in early childhood years.

“In taking another step towards improving services for individuals and families with autism, Michigan’s approval to provide applied behavior analysis services for young children through our Medicaid program is great news for Michigan,” said Lieutenant Governor Brian Calley. “Support such as this not only from Michigan but now also from the federal government is a sign that we are clearly on the right path to making Michigan a place where families living with autism will be able to thrive.”

In Oct. 2012, Michigan’s Autism Insurance Reform legislation was implemented that mandated for-profit, commercial, HMO, and non-profit health insurance companies regulated by the state of Michigan to provide coverage for services related to the diagnosis and treatment of ASD through 18 years of age.

To ensure consistency with state coverage, Michigan applied for approval from CMS to provide coverage for Michigan Medicaid. With this approval, within the first year MDCH is expecting to serve approximately 1,600 children with autism with ABA services. Children eligible for the ABA benefit are also eligible for other medically necessary services, such as speech therapy, occupational therapy, and more.

MDCH will be collaborating with many organizations to provide a wide array of trainings for providers about diagnostic tools, measurement tools, applied behavior analysis, recording of performance measures, and other essential skills needed to provide quality services. These trainings will allow for Michigan to ensure that services are available now that the coverage has been approved.

To utilize the new Medicaid and MIChild ABA coverage, contact a local community mental health (CMH) service program. For a list of local CMH programs, information about Michigan’s Autism Insurance Reform, or the Michigan Autism Program, visit