ABA Therapy Centers in Wisconsin

ForwardHealth behavioral treatment benefit

ForwardHealth began covering a behavioral treatment benefit on January 1, 2016, after CMS directed states to cover autism treatment under the Medicaid State Plan. A member must be enrolled in BadgerCare Plus, Medicaid, or the Katie Beckett Program and have a diagnosed need for behavioral treatment. The provider must be Medicaid-enrolled as a behavioral treatment provider and obtain prior authorization from ForwardHealth before billing.

• Autism treatment moved off the CLTS Waiver onto this Medicaid benefit.
• Providers send commercial coordination-of-benefits questions to a dedicated ForwardHealth mailbox, so tell your agency about any private plan.

Wisconsin autism insurance law, s. 632.895(12m)

Section 632.895(12m) requires disability insurance policies, and self-insured plans of the state, counties, cities, towns, villages and school districts, to cover autism spectrum disorder treatment prescribed by a physician. The minimum is $50,000 a year for intensive-level services (30 to 35 hours a week for at least 4 years) and $25,000 for nonintensive-level services. Those amounts are adjusted yearly for medical inflation, and the Insurance Commissioner publishes the current figures. Ask your plan for this year's number. Private self-funded employer plans follow federal ERISA instead.

Children's Long-Term Support (CLTS) waiver

CLTS is a home and community-based services waiver for children with disabilities, meant to keep kids at home. A child must be younger than 22, be eligible for Wisconsin Medicaid, need a hospital, nursing home or developmental-disability institution level of care, and be able to get safe care at home or in the community. You apply through your county health and human services agency, where a support and service coordinator visits your home and uses an online screen to check eligibility. The state ended the waitlist and now enrolls eligible kids as soon as they qualify.

Birth to 3 Program

Birth to 3 is Wisconsin's early intervention special education program for children under age 3 who have delays or disabilities. A child qualifies with a developmental delay of at least 25% in one or more areas, a physician-diagnosed condition with a high probability of delay, or atypical development that hurts overall development. Referrals go through the Primary Point of Referral in your county or Tribal nation, which you find with the DHS county search.

Special Needs Scholarship Program

The Special Needs Scholarship Program (SNSP) is a state-funded scholarship for a student with a disability to attend a participating private school. A student must be a Wisconsin resident with an IEP or services plan that is currently being implemented, or one developed no earlier than September 15, 2023. For 2026-27, students may apply from July 1, 2026 to June 30, 2027. You submit the paper application directly to the school you choose. The scholarship pays school costs, not therapy.

Who can deliver ABA in Wisconsin

Wisconsin licenses behavior analysts through the Department of Safety and Professional Services under Wis. Stat. ch. 440. Initial licensure requires certification by and registration with the Behavior Analyst Certification Board, and renewal requires current national certification. Ask any agency for the supervising analyst's Wisconsin license, and confirm the agency itself is a Medicaid-enrolled behavioral treatment provider if your child is on ForwardHealth.