ServicesAboutInsuranceService AreasCareersGet started
Home › Insurance › Maryland Medicaid
Coverage guide

Maryland Medicaid covers ABA. We help you put that coverage to work.

Maryland Medicaid covers medically necessary ABA therapy for children under 21. We accept Maryland Medicaid, and we handle it all from the first phone call: free verification, the authorization paperwork, and every renewal after that.

The short answer

Does Maryland Medicaid cover ABA therapy in Maryland?

Yes. Maryland Medicaid covers medically necessary ABA therapy for members under age 21 through a federal benefit called EPSDT, short for Early and Periodic Screening, Diagnostic and Treatment. To use it, your child needs active Medicaid coverage and an autism diagnosis from a qualified professional. There is no separate program to apply for, and the benefit itself has no waitlist.

Families sometimes hear about the Maryland Autism Waiver and assume it is the same thing. It is not. The waiver is a separate program run through the Maryland State Department of Education, with limited slots and a registry that works like a waitlist, and it adds wraparound services such as respite care. You do not need the waiver to use the Medicaid ABA benefit. If your child has Medicaid and a diagnosis, ABA can move forward now.

  • Covers medically necessary ABA for members under age 21
  • No waitlist for the ABA benefit; the Autism Waiver is a separate program
  • We verify your child's coverage for free before anything begins
Check your card

Whatever plan is on the card, we can help.

Your child's Medicaid card probably shows the name of a managed care plan, called an MCO. Here's the part most families never get told: in Maryland, ABA therapy doesn't run through the MCO at all. It's covered through the state's behavioral health system, administered by Carelon Behavioral Health, the same way for every plan.

If any of these names is on your child's card, the ABA benefit works the same:

Priority PartnersMaryland Physicians CareWellpoint MarylandCareFirst Community Health Plan MarylandUnitedHealthcare Community PlanAetna Better HealthMedStar Family ChoiceJai Medical SystemsKaiser Permanente

These are the nine Maryland HealthChoice plans as of 2026. Whichever one you have, we accept Maryland Medicaid, and we verify your child's coverage for free. Not sure what your card says? Reach out or call us and we'll sort it out together.

What we handle

From Medicaid card to first session.

1

Free verification

We confirm your child's Medicaid coverage is active and explain how the EPSDT ABA benefit applies to your family. You share the basics; we make the calls.

2

Authorization

We gather your child's diagnosis paperwork, complete the initial assessment (CPT code 97151 on statements), and submit the authorization request with everything reviewers need.

3

Sessions and billing

Once services are approved, we handle the claims. On paperwork you may see 97153 for one-on-one sessions, 97155 for BCBA plan adjustments, and 97156 for caregiver training.

4

Six-month renewals

Medicaid authorizations renew twice a year. We watch the expiration dates, submit fresh progress data early, and work to keep sessions moving without gaps.

Questions, answered

What parents ask about Medicaid coverage.

Yes. Maryland Medicaid covers medically necessary ABA therapy for members under age 21 through the EPSDT benefit. Your child needs an autism diagnosis from a qualified professional, and services go through an authorization process before they begin. We verify your child's coverage for free and explain what that process looks like for your family.
No. The Autism Waiver is a separate program run through the Maryland State Department of Education, with limited slots and a registry that works like a waitlist. It adds services such as respite care and intensive supports. The Medicaid ABA benefit is a standard medical benefit with no waitlist of its own, so ABA can move forward whether or not your child is on the waiver registry.
The two main items are your child's Medicaid number and the diagnostic evaluation confirming an autism diagnosis from a qualified professional. Records such as an IEP, an IFSP, or earlier assessments help us build a fuller picture, but they are not required to begin. If something is missing, we can help you request copies.
It moves in stages: we confirm coverage, request authorization for the assessment, complete the assessment, and submit the treatment plan for review by the state's behavioral health administrator. Each review has its own timeline, so we do not promise a specific date. We do prepare complete submissions, follow up until there is an answer, and keep you posted at every stage.
Yes. In Maryland, ABA therapy for children under 21 is covered through the state's behavioral health system, administered by Carelon Behavioral Health, not through your managed care plan. So whether your card says Priority Partners, Maryland Physicians Care, Wellpoint, CareFirst Community Health Plan, UnitedHealthcare Community Plan, Aetna Better Health, MedStar Family Choice, Jai Medical Systems, or Kaiser Permanente, the ABA benefit works the same, and we accept it.

One card, one call, and a clear path forward.

Send us your child's basics and we verify your Maryland Medicaid coverage for free, explain the authorization process, and answer every question. No cost, no commitment.

Start Your Free Benefits CheckCall (240) 770-0605
More coverage guides

Other plans we work with.

CareFirst Aetna Cigna UnitedHealthcare TRICARE All insurance details