Does Blue Cross Blue Shield Cover ABA Therapy?
Published April 8, 2026
Yes — Blue Cross Blue Shield (BCBS) covers ABA therapy on most fully-insured commercial plans for individuals with autism spectrum disorder. Because BCBS is a federation of independent regional plans, coverage details vary by state. Here's what you need to know to access ABA through Blue Cross.
Key takeaways
- BCBS covers ABA therapy for autism on most fully-insured commercial plans
- Each state's BCBS plan is independent — coverage details vary by plan and state
- Prior authorization is required for ABA services
- BCBS operates Medicaid plans in several states (e.g., Blue Cross Complete of Michigan, BCBS of MA)
- Self-insured employer BCBS plans follow federal law, not state mandates
How BCBS ABA coverage works
Blue Cross Blue Shield plans classify ABA therapy as a medically necessary treatment for autism spectrum disorder. Most state BCBS plans require:
- A formal autism diagnosis from a licensed professional
- ABA services provided or supervised by a Board Certified Behavior Analyst (BCBA)
- Prior authorization before beginning treatment
- Periodic re-authorizations (typically every 6 months) based on progress
Covered services typically include assessments, direct ABA therapy hours, BCBA supervision, and parent training.
BCBS Medicaid plans
Several BCBS affiliates also operate Medicaid managed care plans, including:
- Blue Cross Complete of Michigan — Michigan Medicaid
- Blue Cross Blue Shield of Massachusetts — MassHealth ACO partner
- BCBS of Minnesota — Minnesota Medical Assistance managed care
- BCBS of Arizona Advantage — AHCCCS (Arizona Medicaid)
- Anthem BlueCross (Medicaid) — operates in 14 states as part of Elevance Health
How to get prior authorization for ABA through BCBS
- Verify your coverage by calling the member services number on your BCBS card or logging into your plan's member portal.
- Obtain an autism diagnosis from a licensed psychologist, developmental pediatrician, or psychiatrist.
- Select an in-network ABA provider using FindABA or your plan's online directory.
- Your provider submits prior authorization — BCBS typically responds within 7–14 business days.
- Begin services once authorization is confirmed in writing.
What if BCBS denies ABA coverage?
If your BCBS plan denies prior authorization, you can appeal the decision. Ask your ABA provider to request a peer-to-peer review with BCBS's medical director. If your plan is fully-insured and your state has an autism mandate, you may also file a complaint with your state insurance department.
Find ABA providers that accept Blue Cross Blue Shield
FindABA lets you search for ABA therapy providers by insurance — including BCBS commercial plans, BCBS Medicaid, and Anthem plans.
Search ABA providers →