Maryland Autism Waiver: Eligibility, Waitlist, and How to Get on the Registry

The Maryland Autism Waiver is a Medicaid 1915(c) Home and Community-Based Services waiver for children and youth with autism. It is run jointly by the Maryland State Department of Education (MSDE) and the Maryland Department of Health (MDH). It pays for services like 1:1 support (IISS), after-school therapeutic programs, respite care, and family consultation, and enrollment also gives the child full Medical Assistance (Medicaid). The number of slots is set by the federal government (CMS), and funding is approved by the Governor and the Legislature. It is governed by COMAR 10.09.56.

A child qualifies if they have a current educational classification of Autism or an ASD diagnosis, are ages 1 through the end of the school year when they turn 21, and are a Maryland resident. They also need an IFSP (ages 1 to 5) or an IEP with at least 15 hours per week of special education and related services (grades 1 and up), must meet ICF-IID institutional level of care, and must meet Medicaid financial limits. For the financial test, only the child's own monthly income counts and may not exceed 300% of SSI, and countable assets may not exceed $2,000 to $2,500. Source: MSDE Autism Waiver fact sheet.

You cannot apply directly. You join the Autism Waiver Registry by calling 866-417-3480, then wait to be invited to apply when a slot opens. Intake runs in three phases: Registry, then Waitlist (after screening), then Wave (invited to apply). Because there is a long waitlist, the single most useful thing to do today is get your child's name on the registry. Confirm the current process at the MDH Autism Waiver page.

It is long, approximately 8 years on average. As of June 2024 (the most recent official figure), the registry held approximately 2,769 individuals, down 59% from 6,705 in June 2023, largely through screening rather than enrollment. Approximately 3,100 slots are now funded (up from 2,950 in FY2024 after SB622 added slots). The End the Wait Act (2022) set a target of 50% registry reduction by FY2024, and that target was not met. The revised goal is a 50% reduction by FY2028. Source: End the Wait JCR (October 2024); updated slot estimates from kidswaivers.org (April 2026). Confirm current figures at the MDH Autism Waiver page before making plans.

The waiver is not a cash scholarship or a fixed dollar award. It funds a set of approved services directly, and enrollment also gives the child full Medical Assistance (Medicaid). Covered services include Intensive Individual Support Services (1:1 support), Therapeutic Integration (after-school or weekend program), Respite Care, Family Consultation, Adult Life Planning, Environmental Accessibility Adaptations, and Residential Habilitation. The dollar value depends on the services in the child's plan, not a flat amount.

Two things, starting now. First, line up ABA or other therapy through private pay or insurance. Maryland's habilitative-services insurance mandate (Insurance Article 15-835) requires state-regulated insurers and HMOs to cover habilitative services such as occupational, physical, and speech therapy for children at least through the end of the month the child turns 19. (That mandate does not cover early-intervention or school-delivered services.) Second, get on the registry today so the clock starts. You do not have to wait for the waiver to begin therapy.

The waiver funds Intensive Individual Support Services (1:1 behavioral support) and other autism services through its provider network of 60+ agencies statewide. Many families also access ABA right now through private insurance or private pay while they sit on the registry. If you have state-regulated insurance, habilitative services for children are covered at least through the month your child turns 19 under Insurance Article 15-835. You do not need the waiver to start ABA.

Maryland restructured Autism Waiver intake into three phases. The Registry is the full list of interested individuals (you join by calling 866-417-3480). The Waitlist is people who have been screened and found preliminarily eligible. The Wave is the group invited to formally apply when slots actually open. Moving from one phase to the next is controlled by the state, not by the family. Source: End the Wait JCR, October 2024.

Yes. The waiver works alongside the child's IEP, not instead of it. In fact, for grades 1 and up the eligibility rules require an IEP with at least 15 hours per week of special education and related services. For ages 1 to 5, an IFSP is used instead. The waiver adds home and community-based services on top of what the school provides.

The waiver uses the child's own income, not the whole household's. The child's monthly income may not exceed 300% of the SSI benefit amount, and countable assets may not exceed $2,000 to $2,500. The child must also meet ICF-IID institutional level of care. Because the financial test looks at the child alone, many families who would not qualify for regular Medicaid on household income can still qualify here. Confirm the current limits with MDH or your local case manager.

No. The Autism Waiver is a Medicaid waiver specifically for children and youth with autism, run by MSDE and MDH. The Developmental Disabilities Administration (DDA) serves people with a developmental disability that began before age 22 and is a separate, longer-term track. Important: DDA eligibility does not guarantee funded services. Approval places you on a waiting list, and services come through a separate Medicaid Waiver application. The DDA-operated waivers shared a waitlist of 4,130 individuals as of August 2024.

No. Maryland does not have a universal Education Savings Account, a K-12 voucher, or a state special-needs scholarship tax credit. The state's only private-school scholarship is BOOST, which is means-tested to families who qualify for free or reduced-price meals and is capped and oversubscribed. If your child's IEP cannot be met in public school, Maryland funds nonpublic special-education placement at public expense through the IEP process, not through a parent application. See our Maryland BOOST and nonpublic placement guides for those paths.

Start with our therapy directory by city (Baltimore, Silver Spring, Rockville, Columbia, Bethesda, Towson) and our Maryland schools directory. You can also tell our concierge about your child and we will connect you with ABA providers and special needs schools that fit your area, insurance, and your child's needs. The concierge is free and does not get you a waiver slot or move you up the list. It helps you build care now while you pursue the waiver.