ABA insurance and Medicaid coverage in Utah
Last researched October 21, 2026
Who pays for ABA in Utah, 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
Utah Code 31A-22-642
- Age limits
As of the version fetched, plans in the individual or large group market entered into or renewed on or after January 1, 2020 must cover diagnosis and treatment of ASD under the section and commissioner rules; the statute text fetched shows no age limit for those plans (earlier 2016-2019 plans covered ages 2 to under 10).
- Annual cap
No cap stated for ABA hours: for individual/large-group plans entered into or renewed on or after Jan 1, 2020, behavioral health treatment coverage 'may not have a limit on the number of hours covered' (earlier plans: at least 600 hours a year).
- Excludes self-funded employer plans
We could not verify this yet - check with your state insurance department.
- Notes
Applies to individual and large group markets only per the statute text (small group is not listed). Behavioral health treatment must be provided or supervised by a BCBA or a licensed mental health professional acting within scope. Treatment plan must be submitted to the insurer within 14 business days of starting treatment; insurer may review not more than once every three months. Plans must include both BCBAs and qualified mental health providers in network. Self-funded (ERISA) status is not addressed in the statute text fetched.
Sources (1)
Medicaid ABA coverage
- Medicaid covers ABA
Yes, per the sources below.
- Program
Utah Medicaid Autism Spectrum Disorder (ASD) Services (ABA therapy)
- Agency
Utah Department of Health and Human Services, Division of Integrated Healthcare (Utah Medicaid)
- Provider enrollment
- https://medicaid.utah.gov/become-medicaid-provider/
Payers named in our research
We could not verify named payers for Utah yet - check with the state Medicaid agency.
How to enroll
- Start at the state Medicaid provider enrollment page: https://medicaid.utah.gov/become-medicaid-provider/.
- 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 Utah.
Related guides for Utah
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