ABA insurance and Medicaid coverage in New Hampshire

Last researched October 21, 2026

Who pays for ABA in New Hampshire, 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

High confidence: read from an official primary source

State mandate for autism coverage: Yes, the research found a state autism coverage law.
Statute: RSA 417-E:2 (Coverage for Treatment of Pervasive Developmental Disorder or Autism), under RSA 417-E:1, III(h)
Age limits: We could not verify this yet - check with your state insurance department.
Annual cap: We could not verify this yet - check with your state insurance department.
Excludes self-funded employer plans: We could not verify this yet - check with your state insurance department.
Notes: RSA 417-E:2 as read (source line: 2022, 337:2, eff. Sept. 23, 2022) requires covered treatment of PDD/autism to include professional services and treatment programs including applied behavioral analysis; to be eligible for coverage, ABA must be provided by a person professionally certified by the BACB or performed under the supervision of one. Also covers prescribed pharmaceuticals, services by licensed psychiatrists/APRNs/psychologists/LCSWs, and licensed speech, occupational and physical therapists. Insurer may require a treatment plan (no more often than semi-annually) signed by a PCP or listed specialist. Coverage may not be denied because services are habilitative. The section as fetched states no age limits or dollar caps; applicability to self-funded plans is not addressed in the section text.

Sources (1)

NH RSA 417-E:2

Medicaid ABA coverage

Medium confidence: reputable secondary source

Medicaid covers ABA: Yes, per the sources below.
Program: NH Medicaid ABA through EPSDT, with service authorization. DHHS's April 14, 2026 guidance confirms coverage under He-W 546 based on individualized medical necessity. Its August 13, 2026 enrollment notice names three Medicaid Care Management plans: AmeriHealth Caritas New Hampshire, NH Healthy Families, and WellSense Health Plan. AmeriHealth Caritas NH's March 2026 provider manual expressly includes ABA within EPSDT.
Agency: NH Department of Health and Human Services, Division of Medicaid Services
Provider enrollment: https://www.nhmmis.nh.gov/portals/wps/portal/ProviderEnrollment

Sources (6)

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.

Medicaid managed care plans

NH Healthy Families (Centene) - Has an ABA clinical policy (CP.MP.104, effective Nov 1, 2018) and payment policy NH.PP.07; prior authorization required.
WellSense Health Plan (NH Medicaid) - Publishes an NH ABA prior authorization form updated 11/14/2025 with a fax and provider portal workflow; initial requests may cover 3 months, continued services 6 months.

Commercial insurers

Ambetter from NH Healthy Families - Named in the 2018 provider fax blast; the ABA clinical policy listed Medicaid as its line of business.

How to enroll

Start at the state Medicaid provider enrollment page: https://www.nhmmis.nh.gov/portals/wps/portal/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 New Hampshire.

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