TEXAS MEDICAID

ABA Therapy Covered by Texas Medicaid

Behavioral Innovations is an approved ABA therapy provider for children enrolled in Texas Medicaid. We serve families across Texas and handle the authorization process so you can focus on your child.

Effective February 1, 2022, Texas Medicaid added ABA evaluation and treatment as a covered benefit for eligible children with autism spectrum disorder. Our intake team will verify your benefits and walk you through every step before the first appointment.

Therapist and child during an ABA session
Texas Medicaid provider

ABA therapy covered through Texas Health Steps

Effective February 1, 2022, the Texas Health Steps Comprehensive Care Program added ABA evaluation and treatment as a covered benefit for children with autism spectrum disorder enrolled in Texas Medicaid who meet program criteria. Behavioral Innovations is an approved provider and serves children ages 18 months through 10 years at our Texas locations.

When enrolling in Texas Medicaid, families are assigned to a Managed Care Organization (MCO), a health plan that varies by location, benefits, and ratings. Your MCO is responsible for authorizing ABA services before treatment can begin.

If you are switching from another ABA provider or have questions about eligibility, our intake team can help you confirm coverage and coordinate next steps.

Texas Medicaid provider
approved for ABA therapy services
Texas locations
serving families across the state
Benefit verification
within one business day
ELIGIBILITY REQUIREMENTS

What your child needs to qualify for ABA through Texas Medicaid

To receive ABA therapy as a Texas Medicaid benefit, four criteria must be met before services can begin.

01

Enroll in Texas Medicaid

Your child must be actively enrolled in Texas Medicaid. Behavioral Innovations serves children ages 18 months through 10 years.

02

Obtain a current ASD diagnosis

A documented autism spectrum disorder diagnosis in your child's medical records is required before services can begin.

03

Request a physician referral or prescription

A valid referral or prescription for ABA therapy from a physician is required.

04

Get prior authorization from your MCO

Your Managed Care Organization must authorize ABA services before treatment starts. Our team can help you navigate this step.

UNDERSTANDING YOUR PLAN

What is an MCO and how does prior authorization work?

Texas Medicaid delivers most benefits through Managed Care Organizations. Understanding your MCO is an important part of accessing ABA therapy.

About MCOs

When you enroll in Texas Medicaid, you choose a Managed Care Organization (MCO), a health plan that manages your benefits.
MCOs vary by region, covered services, and network of providers.
Your MCO must authorize ABA services before treatment can begin. This is called prior authorization.
If you are unsure which MCO you are enrolled in, you can call the Texas STAR Program Helpline at 1-800-964-2777.

Steps to get started

Confirm your child's Medicaid enrollment and MCO assignment
Gather documentation of the ASD diagnosis from your child's medical records
Obtain a referral or prescription for ABA therapy from your child's physician
Contact your MCO to initiate prior authorization. Our team can guide you through it.
READY TO GET STARTED?

We verify your Texas Medicaid benefits within one business day

Our intake team contacts your MCO, confirms your coverage, and calls you with a clear breakdown of what to expect before your child's first appointment.

COVERAGE DETAILS

What Texas Medicaid covers for ABA therapy

Texas Medicaid covers medically necessary ABA evaluation and treatment services for eligible children with a confirmed ASD diagnosis. Coverage is subject to prior authorization from your MCO.

Covered services at Behavioral Innovations

ABA evaluation and treatment services
Personalized 1:1 ABA therapy sessions
Autism assessments and diagnostics
Social skills training
ABA Prep for families awaiting full therapy

Important to know

Prior authorization is required: ABA services cannot begin until your MCO has approved the treatment. Our intake team will help you understand what documentation your MCO needs.
Age eligibility at Behavioral Innovations: Behavioral Innovations serves children ages 18 months through 10 years at our Texas locations.
OUR INTAKE TEAM

We handle the Texas Medicaid process so you can focus on your child

You do not need to understand the prior authorization process before you call. Our intake team verifies your coverage, communicates with your MCO, and guides you through every step.

Call (855) 782-7822
01

Benefit verification within one business day

We contact your MCO, confirm your Texas Medicaid coverage, and call you with a clear breakdown of what to expect before your child's first visit.

02

Prior authorization submitted and tracked

Our team works with your MCO to file the prior authorization request and tracks its status so delays don't fall on your family.

03

Claims filed and followed

We submit claims directly to Texas Medicaid and resolve any denials on your behalf so you are not left navigating the billing process alone.

04

Ongoing support as your child progresses

We handle authorization renewals and keep your child's treatment plan current, so continuity of care is never interrupted.

Texas Medicaid and ABA therapy: frequently asked questions

Does Texas Medicaid cover ABA therapy?

Texas Medicaid can cover medically necessary ABA therapy for qualifying children through Texas Health Steps / EPSDT when criteria are met.

Is Behavioral Innovations an approved Texas Medicaid provider?

Contact our intake team for details specific to your plan. We verify benefits at no charge and explain expected costs before care begins.

What does my child need to qualify for ABA through Texas Medicaid?

Children generally need Medicaid enrollment, a current ASD diagnosis, a physician referral or prescription, and prior authorization from their MCO.

What ages does Behavioral Innovations serve through Texas Medicaid?

Contact our intake team for details specific to your plan. We verify benefits at no charge and explain expected costs before care begins.

What is an MCO?

An MCO (managed care organization) manages Medicaid benefits. Prior authorization from the MCO is typically required before ABA begins.

How do I find out which MCO we are enrolled in?

An MCO (managed care organization) manages Medicaid benefits. Prior authorization from the MCO is typically required before ABA begins.

What is prior authorization and does my child need it?

Behavioral Innovations helps with verification, documentation, and authorization follow-up for Texas Medicaid families.

What services does Behavioral Innovations provide under Texas Medicaid?

Contact our intake team for details specific to your plan. We verify benefits at no charge and explain expected costs before care begins.

How quickly will Behavioral Innovations verify our Texas Medicaid benefits?

We verify Texas Medicaid benefits, typically within one business day, and explain expected next steps.

Can we switch to Behavioral Innovations from another ABA provider?

Contact our intake team for details specific to your plan. We verify benefits at no charge and explain expected costs before care begins.

No Obligation

Questions about Texas Medicaid coverage for ABA therapy?

Our intake team walks every family through their Texas Medicaid benefits, MCO prior authorization, and what to expect before the first appointment. No pressure, no obligation.

  • Texas Health Steps guidance
  • Help with MCO and prior authorization
  • Clear eligibility walkthrough
  • No-cost intake consultation
Call (855) 782-7822

Talk to Our Texas Intake Team

We help Texas Medicaid families understand eligibility and next steps.

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