How States Use Medicaid to Fund Community-Based Services to Children With Autism Spectrum Disorders

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.