Washington Medicaid Autism Coverage
Apple Health (WA Medicaid) covers ABA for children under 21 through the Applied Behavior Analysis Program under EPSDT. The Developmental Disabilities Administration (DDA) administers four HCBS waivers — Basic Plus, Core, CIIBS, and Community Protection — with DDA eligibility as the key gateway.
Quick Answer
Apple Health (WA Medicaid) covers ABA for children under 21 through the Applied Behavior Analysis Program under EPSDT. The Developmental Disabilities Administration (DDA) administers four HCBS waivers — Basic Plus, Core, CIIBS, and Community Protection — with DDA eligibility as the key gateway.
- ABA benefit: covered under EPSDT for under 21 (via epsdt).
- HCBS waivers: 4 relevant waiver options listed on this page.
- Commercial insurance: Washington has a state autism insurance mandate.
Medicaid ABA Coverage
Yes — EPSDT
Under 21 (via EPSDT)
Insurance Mandate
Yes
No dollar cap on medically necessary services
HCBS Waivers
4 available
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
Washington Commercial Insurance Mandate
- Age limit
- No age limit on medically necessary services
- Annual cap
- No dollar cap on 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
- Covers ABA
- Yes
- Age limit
- Under 21 (via EPSDT)
- Prior auth required
- Yes
Apple Health covers ABA through the Applied Behavior Analysis Program, delivered through Apple Health managed care plans. No annual dollar cap on medically-necessary services.
Washington HCBS Waivers
Basic Plus Waiver
Covers autismChildren and adults with IDD living at home — entry-level supports
- Apply via:
- DDA Case Management
Core Waiver
Covers autismIndividuals with IDD needing more intensive supports
- Apply via:
- DDA Case Management
Children's Intensive In-Home Behavioral Support (CIIBS) Waiver
Covers autismChildren with complex behavioral needs at risk of out-of-home placement
- Apply via:
- DDA Case Management
Community Protection Waiver
Covers autismAdults needing intensive community-safety supports
- Apply via:
- DDA Case Management
Katie Beckett / TEFRA Option
Not available
WA does not operate a formal Katie Beckett/TEFRA program. DDA eligibility combined with HCBS waivers provides the functional equivalent for qualifying families.
Early Intervention (Birth–3)
Early Support for Infants and Toddlers (ESIT) — Washington'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 Washington.
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Find providers in Washington
Browse informational listings for therapists, diagnostic centers, and support groups. Confirm details directly.
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Evaluation costs in Washington
Private-pay, insurance, and low-cost options.
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Compare waitlists across 50 states
Sortable table of every state's HCBS waiver waits.