Question 1

Does Wisconsin Medicaid cover ABA therapy?

Accepted Answer

Yes, Wisconsin 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 Wisconsin Medicaid?

Accepted Answer

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

Question 3

Does Wisconsin Medicaid cover ABA therapy for adults over 21?

Accepted Answer

Standard Wisconsin 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 Wisconsin Medicaid?

Accepted Answer

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

Question 5

Does Wisconsin Medicaid require prior authorization for ABA therapy?

Accepted Answer

Yes, prior authorization is required for ABA therapy through Wisconsin 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 Wisconsin?

Wisconsin BadgerCare Plus managed care plans

Wisconsin's autism insurance mandate

How to access ABA through BadgerCare Plus

Wisconsin resources