ABA insurance and Medicaid coverage in Montana
Last researched October 21, 2026
Who pays for ABA in Montana, and what a practice has to do to bill them. Coverage details here come from statutes and agency pages we read, not from payer marketing.
Autism insurance mandate
- State mandate for autism coverage
Yes, the research found a state autism coverage law.
- Statute
MCA 33-22-515
- Age limits
Covered child 18 years of age or younger (per statute text; as of 2026-10-21, confirmed against the 2025 statute version opened by the fact-checker).
- Annual cap
Permitted annual maximum for autism treatment overall (not an ABA-only benefit): $50,000 a year through age 8; $20,000 a year for ages 9-18 (per statute text; no inflation-adjustment provision appears). Actual policy limits were not established.
- Excludes self-funded employer plans
We could not verify this yet - check with your state insurance department.
- Notes
Subsection (1) expressly covers group disability policies, so the earlier uncertainty about private fully insured group coverage is resolved. Individual-policy coverage was not established from the text reviewed. The statute applies to state employee, university system and local government plans, and subsection (8) specifically includes non-ERISA self-funded multiple employer welfare arrangements (not every non-ERISA self-funded arrangement); a blanket self-funded-plan exclusion or inclusion is not supported. The statute lists excluded limited-benefit policies (disability income, hospital indemnity, Medicare supplement, accident-only, vision, dental, specific disease, long-term care). Treatment must be delivered by a provider the statute describes as 'licensed by the behavior analyst certification board' (literal statutory wording; this is distinct from Montana professional licensure) or by a state-certified family support specialist with autism endorsement. History: Chapter 359, Laws of 2009.
Sources (1)
Medicaid ABA coverage
- Medicaid covers ABA
Yes, per the sources below.
- Program
Montana Medicaid Applied Behavior Analysis (ABA) Services
- Agency
Montana DPHHS, Developmental Disabilities Program / Behavioral Health and Developmental Disabilities Division
- Provider enrollment
- https://medicaidprovider.mt.gov/providerenrollment
Payers named in our research
We could not verify named payers for Montana yet - check with the state Medicaid agency.
How to enroll
- Start at the state Medicaid provider enrollment page: https://medicaidprovider.mt.gov/providerenrollment.
- Ask each commercial payer you want to bill for its credentialing application and timeline. We have not verified payer timelines.
- Confirm which staff types the payer reimburses, including whether technicians must hold the RBT credential. See BT vs RBT in Montana.
Related guides for Montana
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