ABA & Medicaid in Illinois

ABA therapy only recently became available as a Medicaid-covered health option in October of 2021. ABA therapy and related services are needed more every year, but can be too expensive for many families. Medicaid coverage can alleviate the financial burden and allow families to get the care they need.

What ABA Services & Programs are Covered by Illinois Medicaid?

The state of Illinois only recently (2021 federal EPSDT mandate) recognized ABA therapy as a valid medical service for ASD and other behavioral issues. Illinois Medicaid can cover the following services:

  • Behavioral health services
  • Licensed clinical psychologists
  • Licensed clinical social workers (LCSW)
  • Board-certified behavioral analysts
  • Registered behavior technicians
  • Specialists in any of the above categories

Clinical psychologists and LCSWs can oversee and evaluate behavioral programs conducted by BCBAs or RBTs. Medicaid funding is required that a state-licensed Licensed Professional of the Healing Arts (like a clinical psychologist and LCSW) supervise BCBA treatment plans for individual plans to cover ABA services. The behavioral programs are created based on individual needs and get input from clients, families, and healthcare professionals. All behavior programs must be formally created using behavioral analyst assessments (like the ABLLS/VB-MAPP) and have measurable goals on their behavioral treatment plan as required by Medicaid.

Finding a Provider for Medicaid ABA Therapy

The biggest hurdle for anyone looking to secure Medicaid-covered ABA services is the lack of providers. ABA therapy is allowed to be covered through Medicaid, but ABA services providers don’t have to accept Medicaid.

The best way to find an ABA service provider that accepts Medicaid is to talk to your child’s doctor or psychologist and ask about clinics or services that accept Medicaid. LCSWs are also a great way to find a provider that accepts Medicaid (LCSW services may be covered under your Medicaid plan).

Medicaid Managed Care for ABA Therapy

Be sure to get information about both the Medicaid All Kids and Managed Care before applying. Managed Care programs are not actually handled by Medicaid–they are handled by contracted insurance providers (In Illinois the providers are Blue Cross Blue Shield IL and Meridian).

While All Kids is directly handled by Illinois Medicaid, Managed Care is handled by contracted outside insurance providers who report to the state. Managed Care programs may make different recommendations based on the insurance provider who manages a given plan. This may happen by recommending children to a specific in-network provider for a given service (in-network for BCBS Community or Meridian).

The coverage varies greatly from All Kids to Managed Care programs, so make sure the services your child needs are covered by any Managed Care program you are considering.

ABA Therapy from IABA Consultants

IABA consultants is now accepting All Kids Medicaid! For details and coverage information, find the location closest to you and give us a call or send us an email.

If you have questions regarding autism treatment, education, or plans to use ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.

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