Does Medicaid Cover ABA Therapy in Texas?
Published April 8, 2026
Yes — Texas Medicaid covers ABA therapy for children and teens under 21 who have an autism diagnosis. Coverage is provided through the STAR and STAR Health managed care programs. Here's exactly how to access it, what's covered, and what to do if you run into barriers.
Key takeaways
- Texas Medicaid covers ABA for all children under 21 with an autism diagnosis
- Coverage is provided through STAR, STAR Health, and STAR Kids managed care plans
- No prior authorization limit on medically necessary ABA hours
- Adults over 21 are not covered unless enrolled in a waiver program
- Texas has hundreds of Medicaid-accepting ABA providers — finding one is the main challenge
Which Texas Medicaid program covers ABA?
Texas Medicaid is administered through managed care organizations (MCOs). Most children with Medicaid are enrolled in one of these plans:
- STAR — the standard Medicaid managed care program for children and families
- STAR Health — for children in foster care or other child protective services involvement
- STAR Kids — for children and young adults under 21 with disabilities, including autism
All three programs cover ABA therapy when it is medically necessary for a child under 21 with an autism spectrum disorder diagnosis. The federal EPSDT mandate requires this — Texas Medicaid cannot legally deny ABA to an eligible child.
What does Texas Medicaid ABA coverage include?
Texas Medicaid covers a broad range of ABA services, including:
- Initial assessment and functional behavior analysis (FBA)
- Direct one-on-one therapy sessions with a Registered Behavior Technician (RBT)
- BCBA supervision and program development
- Parent training and family support sessions
- School-based ABA services in some cases
There is no hard cap on the number of covered hours per week. Hours are based on what is medically necessary as determined by the treating BCBA and approved through prior authorization.
How to get ABA therapy through Texas Medicaid
- Get an autism diagnosis. Your child needs a formal ASD diagnosis from a licensed psychologist, developmental pediatrician, or psychiatrist. Texas Medicaid accepts evaluations from HHSC-approved evaluators.
- Find a Texas Medicaid-enrolled ABA provider. Not all ABA providers accept Medicaid. Use FindABA to filter by your city and insurance to find providers that accept Texas Medicaid.
- Complete an initial assessment. The provider will conduct a skills assessment and functional behavior analysis to determine the appropriate level of care.
- The provider submits a treatment plan. Your BCBA submits the treatment plan and hours to your MCO for prior authorization.
- Authorization is typically granted within 3–14 days. Once approved, therapy can begin.
What about adults over 21?
Standard Texas Medicaid does not cover ABA therapy for adults over 21. However, adults with autism may be able to access behavioral services through:
- The HCS (Home and Community-based Services) waiver — provides residential and day services for adults with intellectual disabilities, including autism. Waitlists can be very long.
- The Texas IDD waiver programs — contact your local LIDDA (Local Intellectual and Developmental Disability Authority) to apply.
- STAR+PLUS — for adults who are elderly or have disabilities, though ABA-specific coverage is limited.
Common problems and how to solve them
| Problem | Solution |
|---|---|
| Can't find a Medicaid provider | Many providers only advertise commercial insurance. Search FindABA and filter by Texas Medicaid, or call providers directly and ask if they have a Medicaid waitlist. |
| Prior auth denied | File an appeal with your MCO. Get a letter of medical necessity from your child's diagnosing physician. Most appeals are successful with supporting documentation. |
| Hours reduced | The MCO cannot reduce hours below what is medically necessary. If hours are cut, request a peer-to-peer review between your BCBA and the MCO's medical director. |
| Provider dropped Medicaid | This happens, especially with smaller providers. Ask your MCO for an out-of-network exception or transition of care authorization while you find a new provider. |
Texas-specific resources
- Texas Health and Human Services (HHS): hhs.texas.gov — manages Medicaid enrollment and MCO contracts
- Autism Society of Texas: autism-society.org/texas — local chapter resources and advocacy support
- Texas Parent to Parent: txp2p.org — peer support for families navigating the system
Find Texas ABA providers that accept Medicaid
FindABA lists ABA providers across Texas with their accepted insurance plans, including Texas Medicaid and STAR Health.
Search Texas providers →