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Insurance & Coverage Guide

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

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

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

Applied Behavior AnalysisSpeech therapyOccupational therapyDiagnostic 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 autism

Individuals with IDD needing comprehensive supports

Waitlist:Waitlist; varies by region
Apply via:Regional DPHHS Developmental Disabilities Program (DDP) Case Management

Big Sky Waiver

Medically complex

Adults with physical disabilities and older adults

Apply via:Senior and Long Term Care Division

Community First Choice (CFC) 1915(k) state-plan option

Covers autism

Medicaid-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 InterventionMontana'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 Montana.