ABA insurance and Medicaid coverage in Kansas

Autism insurance mandate

State mandate for autism coverage

Yes, the research found a state autism coverage law.

Statute

K.S.A. 40-2,194

Age limits

As of 2026-10-21, K.S.A. 40-2,194 requires ABA coverage for covered individuals under age 12 ("less than 12 years"). Applies to large group plans delivered, issued for delivery, amended or renewed on or after 1/1/2015, and to grandfathered individual/group plans on or after 1/1/2016. The under-12 limit applies to the ABA mandate only; subsection (a)(3) expressly exempts required non-ABA autism coverage from these age and hour limitations.

Annual cap

ABA hour caps: 1,300 hours per calendar year for four years applies to individuals diagnosed between birth and five years of age, beginning on the later of diagnosis or January 1, 2015. Otherwise, 520 hours per calendar year applies to covered individuals under 12 ("except as provided in subparagraph (A), 520 hours per calendar year"). Either limit may be exceeded only with prior plan approval and when medically necessary.

Excludes self-funded employer plans

It depends.

Notes

The statute text does not itself expressly address ERISA/self-funded plans. The exclusion of self-insured employer plans comes from the Kansas Health Institute summary (secondary source), which states: "The mandate does not apply to insurance offered by employers who 'self-insure,'". This does not establish that such plans never cover ABA; a self-funded plan may choose to cover it. Reimbursement for ABA beginning on July 1, 2016 is limited to providers licensed or exempt under the ABA licensure act, plus autism specialists, intensive individual service providers and others qualified under the KDADS HCBS autism waiver.

Medicaid ABA coverage

Medicaid covers ABA

Yes, per the sources below.

Program

KanCare (Medicaid/CHIP) EPSDT autism services: Consultative Clinical and Therapeutic Services (CCTS, also known as Autism Specialist Services) and Intensive Individual Supports (IIS)

Agency

Kansas Department of Health and Environment (KDHE) / KMAP; KDADS for the HCBS autism waiver

Provider enrollment

We could not verify this yet - check with Kansas Department of Health and Environment (KDHE) / KMAP; KDADS for the HCBS autism waiver.

Payers named in our research

Names come from the research behind this page. Appearing here does not mean a payer is accepting new providers or that networks are open. Always confirm directly with the payer.