ABA Therapy Centers in Minnesota

EIDBI: Medical Assistance coverage for autism treatment

EIDBI is a Minnesota Health Care Program for people under 21 with autism or a related condition. A child qualifies with a CMDE that establishes medical necessity, an eligible diagnosis, and enrollment in Medical Assistance, MinnesotaCare or MA-TEFRA. A licensed physician, advanced practice nurse, physician assistant or mental health professional makes the diagnosis. Covered treatment follows an individual treatment plan, and progress monitoring is due after every six months of treatment.

• Approved models: applied behavior analysis, DIR/Floortime, Early Start Denver Model and Relationship Development Intervention.
• Anyone can make the EIDBI referral, including a parent, school professional or care coordinator.
• An EIDBI agency delivers the services once the CMDE establishes medical necessity.

Minnesota's autism insurance law for large employers

Minnesota Statutes 62A.3094 requires a health plan issued to a large employer to cover diagnosis, evaluation and medically necessary care for children under 18 with autism, including all types of applied behavior analysis. A large employer has more than 50 current employees. The statute sets no dollar cap. Plans can request an updated treatment plan only once every six months and can require an independent progress evaluation. Self-funded employer plans follow federal ERISA rules instead, so ask HR whether your plan is fully insured in Minnesota.

Disability waivers, TEFRA and the delayed waiver redesign

Minnesota runs four disability waivers: Developmental Disabilities (DD), Community Access for Disability Inclusion (CADI), Community Alternative Care (CAC) and Brain Injury (BI). For the DD waiver, the county arranges the needs assessment, so start with your county. The MA-TEFRA option covers children under 19 who meet disability and level-of-care rules. DHS is building a new Disability Waiver Program but cannot launch it by January 1, 2027, and no new date is set.

Help Me Grow and school-based Early Intervention

Help Me Grow is Minnesota's referral line for children from birth to age five. Call 1-866-693-4769 or refer online; anyone can refer, and the local school district contacts the family. Districts and special education cooperatives provide infant and toddler services before age three and preschool special education from three to five. Services are free regardless of income or immigration status. Eligibility and the service plan are due within 45 calendar days of referral for birth through age two.

Licensed behavior analysts in Minnesota

The Minnesota Board of Psychology licenses behavior analysts under Minnesota Statutes 148.9981 to 148.9995. Since January 1, 2025, a person may not practice applied behavior analysis without that license unless exempt. Applicants need current Board Certified Behavior Analyst certification or its equivalent. An EIDBI qualified supervising professional must be a licensed mental health professional or a licensed behavior analyst, so ask any agency who supervises your child's plan and for that license.