How much does an autism evaluation cost in Massachusetts?

In Massachusetts, a comprehensive private-pay autism evaluation typically costs $2,500–$5,500, with a typical price around $4,000.

Does Massachusetts Medicaid cover evaluations?

Yes. Massachusetts Medicaid covers autism evaluations ($0 copay) under EPSDT.

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Evaluation Cost Guide

Autism Evaluation Cost in Massachusetts

Q: Does insurance cover autism evaluations in Massachusetts?

$0–$1,200 depending on deductible. ARICA requires state-regulated plans to cover diagnosis and medically necessary treatment with no age limit and no annual dollar cap. Self-funded ERISA plans are exempt — confirm your plan type.

Massachusetts has one of the strongest autism-coverage environments in the country. Private-pay evaluations run $2,500–$5,500. ARICA requires commercial plans to cover evaluations with no dollar cap. MassHealth covers evaluations for children under 21, and CommonHealth extends MassHealth to children with disabilities regardless of income.

Quick Answer

Private-pay range: $2,500-$5,500 (typical about $4,000).
Commercial insurance: $0–$1,200 depending on deductible.
Medicaid: covered with a typical copay of $0.

Private-pay (no insurance)

$2,500 – $5,500typical: ~$4,000

For a comprehensive pediatric evaluation (history, ADOS-2, cognitive testing, written report). Updated 2026-04-21.

Commercial Insurance

$0–$1,200 depending on deductible

Typical out-of-pocket

ARICA requires state-regulated plans to cover diagnosis and medically necessary treatment with no age limit and no annual dollar cap. Self-funded ERISA plans are exempt — confirm your plan type.

Medicaid

Typical copay

MassHealth covers evaluations under EPSDT. CommonHealth provides MassHealth access to children with disabilities regardless of family income via sliding-scale premium.

Wait Times

3–6 months

Private psychologist

Major center: 12–18 months (Boston Children's Autism Spectrum Center, Mass General Lurie Center)

Editorial Review

Cost ranges on this page are directional estimates compiled from published price lists, public fee schedules, and manual review.

Actual charges depend on the provider, testing scope, insurance contract, and your deductible or network status. Confirm fees and prior authorization requirements before scheduling.

Last reviewed 2026-04-21 by Autism Hearts Editorial Team

Wait Times by Provider Type

Major medical center: 12–18 months (Boston Children's Autism Spectrum Center, Mass General Lurie Center)
Private psychologist: 3–6 months
Telehealth: 4–8 weeks at telehealth-first practices

Getting on multiple waitlists simultaneously is strongly recommended. Telehealth and private-practice waits are often significantly shorter than academic medical centers.

Low-Cost & Free Evaluation Options in Massachusetts

E.K. Shriver Center at UMass Chan (UCEDD)

universitySliding scale

Worcester / Waltham

Sliding-scale evaluations and research-study access.

Boston Medical Center — Autism Program

university

Boston

Accepts Medicaid (MassHealth).

CommonHealth (MassHealth category)

state fundedFree if eligible

Provides MassHealth coverage to children with disabilities regardless of family income.

Autism Insurance Resource Center (AIRC)

state funded

Statewide (UMass Chan)

Free statewide help with insurance denials, appeals, and coverage navigation.

Massachusetts Medicaid coverage details

Full breakdown of HCBS waivers, ABA benefit rules, and the state insurance mandate.

View Medicaid →

Sources

These sources support the current pricing and coverage context for Massachusetts. Always confirm the latest quote directly with the provider before booking.

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