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Brief Reports   |    
How States Use Medicaid to Fund Community-Based Services to Children With Autism Spectrum Disorders
Rafael M. Semansky, M.P.P., Ph.D.; Ming Xie, M.S.; Lindsay J. Lawer, M.S.; David S. Mandell, Sc.D.
Psychiatric Services 2013; doi: 10.1176/appi.ps.201200390
View Author and Article Information

Dr. Semansky is affiliated with the Health Group, Econometrica, Inc., 7475 Wisconsin Ave., Suite 1000, Bethesda, MD (e-mail: rsemansky@econometricainc.com). Ms. Xie and Dr. Mandell are with the Department of Psychiatry, Perleman School of Medicine, University of Pennsylvania, Philadelphia. Ms. Lawer is with the A. J. Drexel Autism Institute, Drexel University, Philadelphia.

Copyright © 2013 by the American Psychiatric Association


Objective  This study examined the extent to which state Medicaid agencies funded 16 services for children with autism spectrum disorders: individual therapy, physical and occupational therapy, in-home supports, speech therapy, diagnostic assessment, behavior modification, family therapy, case management, targeted case management, respite, day treatment, social skills training, habilitation services, treatment planning, family education and training, and assistive communication devices.

Methods  Procedure codes in the Medicaid Analytic eXtract (MAX) “other therapies” file were used to identify community-based services commonly delivered to children with a diagnosis of a primary autism spectrum disorder.

Results  Four services are commonly used to address the core deficits of these disorders: physical and occupational therapy, speech therapy, behavior modification, and social skills training. Only six states funded all four services.

Conclusions  States varied considerably in use of Medicaid to reimburse these services, indicating that some states may have opportunities to receive federal matching funds.

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Table 1Medicaid funding in 48 states of 16 services for children with a primary diagnosis of autism spectrum disorder, 2005a
Table Footer Note

a Because of poor data quality, no data are presented for Maine, Colorado, and the District of Columbia.



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