Oregon Medicaid Autism Coverage
Oregon Health Plan covers ABA via CCOs under EPSDT. Oregon's 1915(k) Community First Choice (K Plan) provides attendant care, skills training, and behavior supports as a state-plan benefit, meaning no waitlist for eligible individuals.
Quick Answer
Oregon Health Plan covers ABA via CCOs under EPSDT. Oregon's 1915(k) Community First Choice (K Plan) provides attendant care, skills training, and behavior supports as a state-plan benefit, meaning no waitlist for eligible individuals.
- ABA benefit: covered under EPSDT for under 21 (via epsdt).
- HCBS waivers: 3 relevant waiver options listed on this page.
- Commercial insurance: Oregon has a state autism insurance mandate.
Medicaid ABA Coverage
Yes — EPSDT
Under 21 (via EPSDT)
Insurance Mandate
Yes
No dollar cap for medically-necessary services
HCBS Waivers
3 available
Waitlist: No waitlist — state-plan benefit
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
Oregon Commercial Insurance Mandate
- Year enacted
- 2013
- Age limit
- Coverage for ABA required for plans regulated by the state
- Annual cap
- No dollar cap for medically-necessary services
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
Oregon Health Plan covers Applied Behavior Analysis through coordinated care organizations (CCOs) when medically necessary.
Oregon HCBS Waivers
Community First Choice (K Plan, 1915(k))
Covers autismMedicaid-eligible individuals with qualifying functional needs
Children's Intensive In-Home Services (CIIS) / Behavioral Model Waiver
Covers autismChildren with intensive behavioral or medical needs
Adult Comprehensive / Support Services Waivers
Covers autismAdults with IDD
Katie Beckett / TEFRA Option
Not available
Oregon does not operate a traditional Katie Beckett/TEFRA program; institutional deeming under DD Services and the K Plan fills much of this role for eligible children.
Early Intervention (Birth–3)
Early Intervention / Early Childhood Special Education (EI/ECSE) — birth through age 5 — Oregon'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 Oregon.