Montana Medicaid Autism Coverage
Montana Medicaid covers ABA for children under 21 under EPSDT. The 0208 Comprehensive DD Waiver is the main long-term supports pathway, with a waiting list. Community First Choice (1915(k)) offers personal-care services with no waitlist for Medicaid-eligible individuals at institutional level of care. Montana does not run a Katie Beckett / TEFRA program.
Quick Answer
Montana Medicaid covers ABA for children under 21 under EPSDT. The 0208 Comprehensive DD Waiver is the main long-term supports pathway, with a waiting list. Community First Choice (1915(k)) offers personal-care services with no waitlist for Medicaid-eligible individuals at institutional level of care. Montana does not run a Katie Beckett / TEFRA program.
- ABA benefit: covered under EPSDT for under 21 (via epsdt).
- HCBS waivers: 3 relevant waiver options listed on this page.
- Commercial insurance: Montana has a state autism insurance mandate.
Medicaid ABA Coverage
Yes — EPSDT
Under 21 (via EPSDT)
Insurance Mandate
Yes
HCBS Waivers
3 available
Waitlist: Waitlist; varies by region
About this information
This page summarizes public Medicaid, waiver, and insurance-mandate information for general reference.
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
Montana Commercial Insurance Mandate
- Statute
- M.C.A. § 33-22-515 (Montana autism coverage law)
- Age limit
- Through age 18 (per statute; some plans extend coverage)
Covered services
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)
- Prior auth required
- Yes
Montana Medicaid covers medically necessary ABA under EPSDT for children under 21. Healthy Montana Kids (CHIP) also covers autism services for eligible children.
Montana HCBS Waivers
0208 Comprehensive Developmental Disabilities Waiver
Covers autismIndividuals with IDD needing comprehensive supports
- Waitlist:
- Waitlist; varies by region
- Apply via:
- Regional DPHHS Developmental Disabilities Program (DDP) Case Management
Big Sky Waiver
Medically complexAdults with physical disabilities and older adults
- Apply via:
- Senior and Long Term Care Division
Community First Choice (CFC) 1915(k) state-plan option
Covers autismMedicaid-eligible individuals meeting institutional level of care
- Waitlist:
- No waitlist (state-plan benefit)
- Apply via:
- DPHHS Senior and Long Term Care Division
Katie Beckett / TEFRA Option
Not available
Montana does not operate a traditional Katie Beckett / TEFRA option. Families above standard Medicaid limits typically rely on Healthy Montana Kids (CHIP), waiver eligibility (which uses the child's income), or employer coverage.
Early Intervention (Birth–3)
Montana Milestones / Part C Early Intervention — Montana's IDEA Part C program. Children under 3 with developmental delays can access services without a formal autism diagnosis.
New to waivers? Read our plain-language guide to autism Medicaid waivers, SSI and ABLE accounts, or compare states on the waiver waitlists tracker.
Official Sources
Use these primary sources when you need to confirm current Medicaid rules, waiver access, or state-agency guidance in Montana.