Now Accepting Medicaid for ABA Therapy in Texas!
We are excited to announce that Behavioral Innovations is accepting Texas Medicaid Insurance at our centers.
After years of advocacy by autism support groups and advocates for the inclusion of ABA services as a covered benefit for those with Texas Medicaid, we are excited to welcome Texas Medicaid members to our Behavioral Innovations family.
We are currently accepting Parkland Community Health Plan, Superior HealthPlan, and Amerigroup, and our team is diligently working through the contracting process with Texas Medicaid and other Managed Care Organizations (MCOs) that administer Texas Medicaid on behalf the State. In the meantime, contact our intake team to start the enrollment process, so your child can start services at the earliest.
- Get Added to the Waitlist: Contact Us to indicate your interest and learn more about the enrollment process. While we are expanding Medicaid acceptance through MCO partners, you can add your child's name to the waitlist to ensure you have all the information and documentation needed to expedite enrollment once the contracting process is complete. You will be sent updates as soon as we know more. Contact us to be placed on a waitlist and to be notified of changes.
- Receive a Diagnosis: Receiving a formal diagnosis of autism is a requirement of Texas Medicaid. In need of diagnosis? We can help connect you with leading diagnosing providers in your area. Contact our team for more information.
1. Who is Eligible for Services through Medicaid?
Effective February 1, 2022, Texas Health and Human Services (HHS) added a new Medicaid benefit for Applied Behavior Analysis (ABA) services for individuals under 21 years of age with Autism Spectrum Disorder (ASD).
2. What are the requirements for eligibility?
- Child must be under 21 years of age
- A recent Autism diagnosis is required within the last three years
- Diagnosis must also include the Autism diagnostic level (one, two or three)
- The child must have a referral / prescription for ABA therapy from a physician
- CHIP is not part of this program
3. Is Behavioral Innovations accepting Texas Medicaid?
These are the Texas Medicaid health plans we currently accept:
- Parkland Community Health Plan
- Superior HealthPlan
These are the health plans we anticipate being accepted soon:
- Aetna Better Health
- Cook Children's Health Plan
- Texas Children's Health Plan
4. What is an MCO or Health Plans, and why is it important to know mine?
When you enroll in Texas Medicaid, you will be given a choice of health plans depending on where you live and the program you're enrolled in. Each plan has different doctors, hospitals, clinics, benefits, and ratings from members. Texas Medicaid has tools to help you choose the best plan for you and your family.
5. If my MCO or Health Plan is not accepted currently, should I change my plan, so my child is eligible for service?
You should carefully consider all the costs, provider networks, and ratings of each plan and choose the health plan that is best for you and your family.
6. How can I change my health plan?
- STAR, STAR Kids and STAR Plus members: The Texas Medicaid program allows you to change your or your child's health plan.
- You can learn more by calling the Texas STAR Program Helpline at 1-800-964-2777.
- You can request to change your health plan at any time for any reason.
- If you call to request a change your health plan on or before the 15th of the month, usually the change will take place on the first day of the next month.
- If you call to request a change after the 15th of the month, usually the change will take place the first day of the second month after your request. For example:
- If you call on or before October 15, your change will typically take place on November 1.
- If you call after October 15, your change will typically take place on December 1.
7. Medicaid resources
Here are some resources that provide additional information regarding Medicaid acceptance in Texas
8. I have more questions. Who can I contact to know more?
You can learn more by calling the Texas STAR Program Helpline at 1-800-964-2777 or your current health plan at the number on the back of your ID card.
“Behavioral Innovations has really helped our son with his ASD and we've seen vast improvement in his behavior.”