Indiana Seeks CMS Approval To Limit ABA Hours With Lifetime Cap

The Indiana Medicaid program has proposed limiting applied behavior analysis (ABA) coverage to 30 hours per week for children at autism spectrum disorder level 1 and creating a three-year lifetime cap on ABA coverage. Some exceptions to the lifetime cap would be available, based on medical necessity. The new policy is slated to go into effect on April 1, 2025, or as soon as the Centers for Medicare & Medicaid Services (CMS) approves a state plan amendment (SPA) for these changes. The state anticipates that annual expenditures for ABA will decline.

The Indiana Family and Social Services Administration (FSSA . . .