Question 1

Does Oregon Medicaid cover ABA therapy?

Accepted Answer

Yes, Oregon Medicaid covers ABA therapy for children and teens under 21 who have an autism spectrum disorder diagnosis. Coverage is provided through managed care plans at no cost to eligible families.

Question 2

What is the age limit for ABA therapy under Oregon Medicaid?

Accepted Answer

Oregon Medicaid covers ABA therapy for individuals under 21 years old, as required by the federal EPSDT mandate.

Question 3

Does Oregon Medicaid cover ABA therapy for adults over 21?

Accepted Answer

Standard Oregon Medicaid does not cover ABA therapy for adults over 21. Some adults may qualify for behavioral services through Medicaid Home and Community Based Services (HCBS) waiver programs.

Question 4

How do I find ABA providers that accept Oregon Medicaid?

Accepted Answer

Use FindABA to search for ABA therapy providers in Oregon that accept Medicaid. You can also contact your Medicaid managed care plan directly for a list of in-network providers.

Question 5

Does Oregon Medicaid require prior authorization for ABA therapy?

Accepted Answer

Yes, prior authorization is required for ABA therapy through Oregon Medicaid. Your ABA provider will submit the treatment plan to your managed care plan, and authorization typically takes 7–14 business days.

Does Medicaid Cover ABA Therapy in Oregon?

Oregon Health Plan Coordinated Care Organizations

Oregon's autism insurance mandate — all ages

How to access ABA through the Oregon Health Plan

Oregon resources