Resources · ABA therapy
Getting started with ABA therapy through Maryland Medicaid
Who qualifies, which documents you need, and the steps from an autism diagnosis to the first in-home ABA session.
Applied behavior analysis (ABA) helps children and young adults with autism build communication, daily living, and social skills, and reduce behaviors that get in the way. Maryland Medicaid covers ABA for eligible members under 21. Here’s how the process works.
Who qualifies
To receive ABA through Maryland Medicaid, your child needs:
- To be under 21 and enrolled in Maryland Medicaid
- To live at home or in a community setting
- An autism spectrum disorder diagnosis from a comprehensive diagnostic evaluation
- A referral for ABA from a qualified health care professional
- Prior approval from Carelon Behavioral Health, which our office requests
Who can diagnose and refer
A developmental pediatrician, pediatric neurologist, child psychiatrist, clinical psychologist or neuropsychologist, pediatrician, or nurse practitioner. Hearthway doesn’t diagnose autism, so if your child hasn’t been evaluated yet, start with your pediatrician.
Documents to gather
- Your child’s Maryland Medicaid card
- The comprehensive diagnostic evaluation report
- The ABA referral
- The Clinical Confirmation Form, if your child’s age and date of diagnosis require it
- Your child’s IEP or 504 plan, if they have one
The steps
- Referral. You, your pediatrician, or another provider sends us a referral.
- Eligibility check. We confirm Medicaid coverage and review the diagnosis and referral documents.
- Assessment and treatment plan. A board certified behavior analyst assesses your child’s skills and behaviors and writes a treatment plan with you.
- Approval. We request approval from Carelon Behavioral Health.
- Sessions begin. Behavior technicians work with your child at home and in the community, under the behavior analyst’s supervision.
Approvals last up to 180 days. Before each one ends, your child is reassessed and the plan is updated.
Where sessions happen
Hearthway provides ABA in the home and community in all 24 Maryland jurisdictions. Learn more on our ABA therapy page, or call (443) 824-4842 and we’ll help you check what you have.
This article is general information, not medical advice. For questions about your own care, talk with your clinician. In a crisis, call or text 988, or call 911 in an emergency.
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