ABA Therapy Centers in West Virginia

West Virginia Medicaid and CHIP ABA coverage

The Bureau for Medical Services covers ABA for Medicaid children from 18 months through age 20 with a primary autism diagnosis made before the eighth birthday. Providers must request prior authorization before services start. The request includes a diagnostic assessment completed within 24 months, an annual physician's order and a signed statement that ABA does not duplicate school services. WVCHIP covers ABA too, with requests filed through KEPRO.

• Diagnosis must come from a physician (such as a neurologist, developmental pediatrician or psychiatrist) or a licensed psychologist.
• Medicaid recognizes BCBAs, BCaBAs and RBTs whose BACB certification is current.
• Services that are educational in nature cannot be authorized.

Autism coverage under W. Va. Code § 33-16-3v

Group accident and sickness policies issued in West Virginia must cover autism diagnosis and treatment, including ABA, for ages 18 months to 18 years when the diagnosis came at age 8 or younger. ABA is capped at $30,000 a year for three years from the start of treatment, then $2,000 a month until age 18. The law excludes employers with 25 or fewer eligible employees. Self-funded employer plans follow federal ERISA, so ask HR how your plan is funded.

The IDD Waiver and Medicaid Personal Care

The Intellectual and/or Developmental Disabilities Waiver (IDDW) serves people age three and older with an intellectual disability or similar condition that began before age 22 and limits in at least three of six life areas. Applications go to Acentra Health, and a state-approved psychologist completes the evaluation. Approved applicants without an open slot join a managed enrollment list. Children over three may also qualify for the Medicaid Personal Care Program.

• Acentra Health help line: 866-385-8920.
• Waitlist Support Grant: Developmental Disabilities Division at 304-356-4811.
• Approval typically takes 90 to 105 days from application.

West Virginia Birth to Three

Birth to Three is the state's Part C early intervention system for infants and toddlers under age three who have a developmental delay or are at risk of one. A condition typically associated with delay, such as autism, also qualifies. Services cost families nothing for what the Individualized Family Service Plan lists, and they happen in natural settings like home. Parents, pediatricians and hospitals all refer. Call 1-866-321-4728 to reach the regional office for your county.

Hope Scholarship education savings accounts

The Hope Scholarship is West Virginia's education savings account program. For 2026-27, any West Virginia resident in grades K-12 who is under 21 and has not finished secondary school can apply. The projected award is $5,435.62. Funds can pay tuition at a participating school or microschool, but a child cannot stay in public school full-time and also take part. Ask the Hope Scholarship Board whether a specific therapy counts as an approved expense.

Who can deliver ABA in West Virginia

West Virginia does not appear on the BACB's list of states that require licensure for behavior analysts. Payers instead look to national certification. Medicaid recognizes BCBAs, BCBA-Ds, BCaBAs and RBTs with current BACB certification, and the insurance law requires ABA to be provided or supervised by a certified behavior analyst. Ask any provider for the supervising BCBA's certification number and verify it with the BACB.