Which States have the Highest Autism Therapy Reimbursement in 2026?
Among the states analyzed for 2026, Arizona is projected to have the highest average Medicaid reimbursement rate for CPT code 97153 (adaptive behavior treatment), followed closely by Maryland.
According to the 2026 projections for Medicaid fee schedules, the rates per unit are:
- Arizona: Projected average rate of $13.50 per unit (despite a 3.6% reduction from 2025).
- Maryland: Projected average rate of $13.50 per unit (reflecting a 1.8% decrease from 2025).
- Utah: Projected average rate of $12.25 per unit (reflecting a 2% decrease from 2025).
While Arizona and Maryland are projected at the same average rate, Arizona historically started from a higher 2025 baseline ($14.00) compared to Maryland ($13.75).
It is important to note that these figures apply specifically to Medicaid. Private insurance reimbursement rates are negotiated between employer health plans and provider networks and typically offer different, often more flexible, rate structures compared to state-legislated Medicaid budgets.
Related FAQs
-
How do I Start Aba Therapy with Cigna in Utah?
Read More »: How do I Start Aba Therapy with Cigna in Utah?To start ABA therapy with Cigna in Utah through Golden Touch ABA, you should follow these six steps: Verify Benefits: Contact Cigna to confirm coverage for ABA therapy. Utah state mandates generally require coverage for children up to age 21…
-
Which Aba Therapy Providers in Utah Accept Cigna Insurance?
Read More »: Which Aba Therapy Providers in Utah Accept Cigna Insurance?Based on the provided content, Golden Touch ABA Therapy is a primary provider in Utah that accepts Cigna insurance. They offer specialized, in-home ABA therapy led by Board Certified Behavior Analysts (BCBAs) and implemented by Registered Behavior Technicians (RBTs). Golden…
-
How Much does Aba Therapy Cost with Cigna Coverage in Utah?
Read More »: How Much does Aba Therapy Cost with Cigna Coverage in Utah?The cost of Applied Behavior Analysis (ABA) therapy with Cigna coverage in Utah is influenced by state mandates and specific policy details. Under Utah law, fully insured plans like Cigna are required to cover ABA therapy for eligible individuals with…
-
What are the Requirements for Cigna to Approve Aba Therapy for Children in Utah?
Read More »: What are the Requirements for Cigna to Approve Aba Therapy for Children in Utah?To secure approval for ABA therapy through Cigna in Utah, families must meet several specific state and insurance requirements. First, the child must have a formal autism diagnosis from a licensed physician. Under Utah’s autism insurance mandate, coverage is typically…
-
Does Cigna Insurance Cover Aba Therapy in Utah?
Read More »: Does Cigna Insurance Cover Aba Therapy in Utah?Yes, Cigna insurance covers ABA therapy in Utah. Under Utah’s autism insurance mandate, plans like Cigna are required to cover Applied Behavior Analysis (ABA) therapy for eligible children and young adults with an autism diagnosis up to age 21. This…
