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Insurance & Coverage Guide

California Medicaid Autism Coverage

California offers both Medi-Cal ABA coverage and lifelong Regional Center services regardless of income. SB 946 requires commercial insurers to cover behavioral health treatment with no age limit or dollar cap.

Quick Answer

California offers both Medi-Cal ABA coverage and lifelong Regional Center services regardless of income. SB 946 requires commercial insurers to cover behavioral health treatment with no age limit or dollar cap.

  • ABA benefit: covered under EPSDT for under 21 (via epsdt); adults via medi-cal bht in certain plans.
  • HCBS waivers: 2 relevant waiver options listed on this page.
  • Commercial insurance: California has a state autism insurance mandate.

Medicaid ABA Coverage

Yes — EPSDT

Under 21 (via EPSDT); adults via Medi-Cal BHT in certain plans

Insurance Mandate

Yes

No cap

HCBS Waivers

2 available

Editorial Review

This page summarizes public Medicaid, waiver, and insurance-mandate information reviewed by the Autism Hearts editorial team.

Medicaid benefits, managed-care rules, and waiver waitlists can change quickly, so families should verify eligibility, prior authorization, and enrollment steps with the administering agency before relying on this page.

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

California Commercial Insurance Mandate

Statute
SB 946 (Health and Safety Code § 1374.73)
Year enacted
2011
Age limit
No age limit
Annual cap
No cap

Covered services

Behavioral health treatment (ABA)Speech therapyOccupational therapy

Self-funded employer plans (often from large employers) are regulated by federal ERISA law, not state mandates, and may be exempt. Always confirm your plan type on your Summary of Benefits and Coverage.

Medicaid ABA Therapy Benefit

Covers ABA
Yes
Age limit
Under 21 (via EPSDT); adults via Medi-Cal BHT in certain plans
Prior auth required
Yes

Medi-Cal covers Behavioral Health Treatment (BHT) including ABA when medically necessary.

California HCBS Waivers

Home and Community-Based Services for the Developmentally Disabled (HCBS-DD)

Covers autism

Regional Center consumers

Apply via:Local Regional Center

Self-Determination Program (SDP)

Covers autism

Regional Center consumers electing self-direction

Apply via:Local Regional Center

Katie Beckett / TEFRA Option

AvailableInstitutional Deeming / Home and Community-Based Waiver for Developmentally Disabled (HCBS-DD)

CA uses institutional deeming via Regional Centers rather than a traditional TEFRA program.

Early Intervention (Birth–3)

Early StartCalifornia's IDEA Part C program. Children under 3 with developmental delays can access services without a formal autism diagnosis.

Official Sources

Use these primary sources when you need to confirm current Medicaid rules, waiver access, or state-agency guidance in California.