ABA Therapy Centers in Missouri

MO HealthNet ABA under 13 CSR 70-98.030

MO HealthNet covers ABA for participants under 21. A licensed physician or licensed psychologist must diagnose autism spectrum disorder and recommend ABA as medically necessary, and the child must show behaviors that interfere with home or community activities, such as aggression, self-injury or elopement. A licensed behavior analyst, or a licensed psychologist with ABA training, directs services. MO HealthNet or its designee precertifies ABA for up to 180 days at a time, and services delivered without precertification are not reimbursed except with retroactive eligibility.

• Eastern Region of MO HealthNet Managed Care: St. Louis City and St. Louis, St. Charles and Jefferson counties, among others.
• Western Region: Jackson, Clay, Cass and Platte counties, among others.
• Southwest Expansion: Greene, Jasper, Christian and Taney counties, among others.

Section 376.1224 and the $40,000 ABA benefit

Section 376.1224 of the Revised Statutes of Missouri requires health benefit plans delivered, issued or renewed on or after January 1, 2020 to cover autism diagnosis and treatment, including ABA ordered by a licensed physician or psychologist under a treatment plan. ABA is capped at $40,000 per calendar year through age 18, and a plan can approve more in advance when medically necessary. The cap is indexed for inflation: the Department of Commerce and Insurance calculates the current figure and the Missouri Register publishes it, so ask your plan for this year's number.

Sarah Lopez Waiver and DD regional offices

The Missouri Children with Developmental Disabilities Waiver, also called the Sarah Lopez Waiver, grants Medicaid eligibility to children under 18 who would qualify for MO HealthNet in an institution but live at home. The state looks only at the child's income. The Department of Mental Health, Division of Developmental Disabilities administers it, and its regional offices handle eligibility determination. Call the office for your county to start.

• Kansas City Regional Office: 816-889-3400.
• St. Louis Regional Office: 314-587-4800.
• Springfield Regional Office: 417-895-7400.
• Central Missouri Regional Office (Columbia): 573-441-6278.

First Steps from birth to age three

First Steps is Missouri's early intervention system for infants and toddlers from birth to age three who have developmental delays or diagnosed conditions associated with developmental disabilities. The Department of Elementary and Secondary Education runs it, and participation is voluntary. Parents can refer their own child: call 866-583-2392, extension 3, to reach the System Point of Entry for your area, or enter a referral online.

Licensed behavior analysts in Missouri

Missouri licenses behavior analysts under sections 337.300 to 337.340 of the Revised Statutes through the Behavior Analyst Advisory Board. Licensed behavior analysts (LBA) practice applied behavior analysis, licensed assistant behavior analysts (LaBA) work under an LBA's supervision, and licensed psychologists can practice within their training. Under MO HealthNet rules, a psychologist needs ABA education and training to be reimbursed. Use the board's verification of licensure page to check any clinician.

MOScholars for students with an IEP

The Missouri Empowerment Scholarship Accounts program, called MOScholars, awards scholarships through approved nonprofit Educational Assistance Organizations funded by state tax credits. A student with an approved IEP developed under the federal IDEA qualifies; plans that are not IDEA IEPs do not count. The State Treasurer says the money can pay for services ranging from private schools to therapeutic services. Check the Treasurer's MOScholars page for the current application details.