Indiana's Medicaid program no longer covers applied behavior analysis therapy for adults. Under a February bulletin from the Indiana Health Coverage Programs, ABA is covered only through Medicaid's early and periodic screening, diagnostic and treatment benefit for members under 21 starting April 1, 2026. Adults already in care got a transition window that ran through Sept. 30. The bulletin says that for dates of service on or after Oct. 1, 2026, the program "will no longer authorize or reimburse ABA therapy services for members 21 years of age and older."
The same bulletin, BT202627, made other changes that now apply to members under 21.
The ABA changes
- Rates. Individual ABA maximum fees fell 6% for dates of service from April 1, 2026, and group codes moved to rates tiered by group size. A further 4% cut to all ABA codes, individual and group, is scheduled for April 1, 2027.
- A lifetime cap on comprehensive ABA. Members can receive up to 4,000 hours of comprehensive ABA over their lifetimes, based on medical necessity, followed by up to 15 hours a week of targeted ABA. More comprehensive therapy needs a further review by the state, the member's managed care entity or a delegated reviewer.
- School-based ABA is exempt. The lifetime allocation rules do not apply to ABA provided by a school corporation.
Our earlier coverage of ABA rate pressure in New York and Florida has more on how other states are handling the benefit.
What adults on the waivers can use instead
For adults with developmental disabilities on the Community Integration and Habilitation and Family Supports waivers, the remaining route is the waivers' behavior support services. A November 2025 bulletin, BT2025169, retired behavior management basic and the two Intensive Behavioral Intervention levels on Dec. 31, 2025, and replaced them with three behavior support categories from Jan. 1, 2026, authorized each quarter:
| Behavior support service | Limit |
|---|---|
| Consultation | Up to 3 hours a month |
| Comprehensive | Up to 12 hours a month or 144 hours a year |
| Functional behavioral assessment | Up to 20 hours within 60 days |
Each category pays $18.56 per 15 minutes, according to the bulletin, which said the changes were pending CMS approval. A fact sheet from The Arc of Indiana says CMS approved the waiver updates, which took effect Dec. 31, 2025, and that families can appeal for temporary additional hours.
Why this matters for providers and DSPs
Adults who were receiving ABA through Medicaid lost that coverage this month. For those on the CIH or Family Supports waiver, behavior support now tops out at about 12 hours a month of comprehensive services. That leaves more of the day-to-day work of carrying out a behavior support plan with the direct support professionals and families around the person. Residential and day providers may want to identify the adults they support who had ABA hours and talk with their case managers about behavior support under the waiver. ABA agencies serving people under 21 face the second rate cut in April 2027.