Does Medicaid Cover ABA Therapy in Pennsylvania?
Published April 8, 2026
Yes — Pennsylvania Medical Assistance (Medicaid) covers ABA therapy for children and teens under 21 with an autism diagnosis. Pennsylvania calls its Medicaid program "Medical Assistance" (MA) and delivers most services through managed care organizations. Here's how it works.
Key takeaways
- Pennsylvania MA covers ABA for all children under 21 with an autism diagnosis
- Delivered through managed care — Keystone First, UPMC for You, Geisinger, AmeriHealth, and others
- Philadelphia and Pittsburgh have large ABA provider networks
- Pennsylvania also has a commercial insurance autism mandate (Act 62)
- Adults may access behavioral services through the Adult Autism Waiver
Pennsylvania Medicaid plans that cover ABA
Pennsylvania Medical Assistance is delivered through HealthChoices, the state's managed care program. The major MCOs operating in Pennsylvania include:
- Keystone First — southeastern PA, including Philadelphia
- AmeriHealth Caritas Pennsylvania — statewide
- UPMC for You — western PA, including Pittsburgh
- Geisinger Health Plan — central and northeastern PA
- Gateway Health — western and southwestern PA
- Commonwealth Coordinated Care Plus (CCC+) — for members with complex needs
Your assigned plan depends on your county. You can verify your plan or request a change through the Pennsylvania COMPASS portal at compass.state.pa.us.
What Pennsylvania MA covers for ABA
Pennsylvania Medical Assistance covers the following ABA services:
- Behavioral health assessment by a licensed BCBA or psychologist
- Direct ABA treatment — individual and group
- Treatment plan development and modification
- Family training and caregiver support
- Clinical supervision by a BCBA
Pennsylvania requires that ABA providers be licensed as Behavior Specialists (BS) or employ licensed Behavioral Health Technicians (BHT) supervised by a BCBA. When searching for providers, confirm they are licensed under Pennsylvania's behavioral health licensure framework.
Pennsylvania's Act 62 — commercial insurance mandate
If your child has private insurance rather than Medicaid, Pennsylvania's Act 62 requires fully-insured commercial plans to cover ABA therapy. Coverage applies to individuals of all ages — there is no age cutoff under Pennsylvania's commercial insurance mandate. The annual benefit cap was removed in 2017.
Steps to access ABA through Pennsylvania MA
- Confirm your MA plan. Check your ACCESS card, log into COMPASS, or call the MA helpline at 1-800-692-7462.
- Obtain an autism diagnosis. A formal ASD diagnosis is required from a licensed psychologist, psychiatrist, or developmental pediatrician.
- Find an in-network ABA provider. Search your plan's provider directory or use FindABA to search by city.
- Complete intake and assessment. The provider evaluates your child and submits a treatment plan.
- Prior authorization is typically approved within 7–14 days.
- Therapy begins at no cost to you.
Adults with autism in Pennsylvania
Pennsylvania offers the Adult Autism Waiver (AAW) for adults age 21 and older with an autism diagnosis. The waiver provides services including behavioral support, life sharing, and supported employment. Apply through your county's Office of Developmental Programs (ODP) or visit the ODP website at dhs.pa.gov/Services/Disabilities-Special-Needs/Pages/Autism.aspx.
Pennsylvania resources
- PA Department of Human Services: dhs.pa.gov
- COMPASS (benefits portal): compass.state.pa.us
- Autism Society of Greater Philadelphia: autismsocietyphiladelphia.org
- PA MA helpline: 1-800-692-7462
Find Pennsylvania ABA providers that accept Medical Assistance
FindABA lists ABA providers across Pennsylvania showing accepted insurance plans including Keystone First, UPMC for You, and Pennsylvania Medical Assistance.
Search Pennsylvania providers →