ABA Therapy Centers in New York

Medicaid ABA for members under 21

New York Medicaid covers ABA from enrolled Licensed Behavior Analysts and Certified Behavior Analyst Assistants for members under 21 with an autism diagnosis or Rett syndrome. A New York licensed, Medicaid-enrolled physician, psychologist, psychiatric or pediatric nurse practitioner, or physician assistant must refer the child, and a referral stays valid for up to two years. Managed care plans have carried the ABA benefit since January 1, 2023, so call your child's plan for its coverage and billing steps. Medicaid does not pay for ABA delivered in a school setting.

• Effective October 1, 2026, fee-for-service Medicaid pays $9.63 per unit for ABA delivered by technicians (CPT 97153).
• New ABA providers cannot enroll in Medicaid under a temporary moratorium of at least six months announced in July 2026; enrolled providers are not affected.

New York's 680-hour autism insurance mandate

Insurance Law sections 3216(i)(25), 3221(l)(17) and 4303(ee) require policies with physician, medical or major medical coverage to cover autism screening, diagnosis and treatment, including 680 hours of ABA per policy or calendar year for each covered person with an ASD diagnosis. The statute bars visit limits that apply only to autism treatment. A Licensed Behavior Analyst, or a Certified Behavior Analyst Assistant under an LBA's supervision, must provide the ABA. Self-funded employer plans follow federal ERISA rules instead, so ask HR whether your plan is fully insured in New York.

OPWDD and the HCBS waiver

OPWDD describes its Home and Community Based Services (HCBS) waiver as its largest Medicaid program, and it also lists Children's waiver services for children up to age 18 with severe medical needs and a developmental disability. You must be enrolled in Medicaid to join either one. For children living at home, OPWDD may waive parental income and resources when the child seeks waiver enrollment. To begin, call the OPWDD Infoline at 866-946-9733, give your county, and ask to be transferred to your regional Front Door office to start the eligibility review.

The New York State Early Intervention Program

The Early Intervention Program (EIP) serves children under 3 with a confirmed disability or an established developmental delay in physical, cognitive, communication, social-emotional or adaptive development. The Department of Health runs it statewide, and a municipal Early Intervention Official in your county handles each referral. New York City families refer online through the NYC Early Intervention Referral Portal or by calling 311 and asking for Early Intervention.

Licensed Behavior Analysts in New York

New York licenses behavior analysts under Education Law Article 167, which the Education Department's Office of the Professions administers. The state issues two credentials: Licensed Behavior Analyst (LBA) and Certified Behavior Analyst Assistant (CBAA). Insurers must cover ABA only when an LBA, or a CBAA under an LBA's supervision, provides it. Ask any provider for the LBA's license number and verify it on the NYSED license verification page.