ABA therapy in Maine
Maine Medicaid covers ABA for eligible kids, and the state has required private insurance to cover autism care since 2010. Here’s how it actually works — and how we handle the messy parts for you.
Does Medicaid cover ABA in Maine? Yes.
THE COVERAGE PATHWAY
ABA delivered mainly under MaineCare Benefits Manual Section 28 (Rehabilitative & Community Support Services for Children with Cognitive Impairments and Functional Limitations), including BCBA-supervised Specialized Services; Section 65 BH services restructured Jan 2026
WHO RUNS IT
Maine DHHS, Office of MaineCare Services; maine.gov/dhhs/oms, member services 1-800-977-6740
You don’t have to memorize any of this — we work with Maine’s system every day.
Getting approved, in three steps
Maine requires paperwork before therapy is covered. Here’s the whole process from your side of the table — we do the rest.
1
Round up the diagnosis paperwork
An autism diagnosis from a qualified provider is the key that opens coverage. Already have it? You’re ahead. If not, we’ll help you find an evaluation.
2
We build and submit the plan
Your BCBA assesses your child and writes the treatment plan. Then we file it with the right reviewer in Maine — forms, follow-ups, and all.
3
Coverage confirmed. Therapy starts.
Once the plan signs off, sessions begin. Most families who qualify start within 2–3 weeks. Approvals renew on a schedule — we track it so you never think about it.
The fine print, if you want it (Maine’s exact rules)
Services require eligibility determination and individualized treatment plan under Section 28; BCBA supervision built into Specialized Services rate; PA/utilization review through MaineCare's ASO (Kepro/Acentra)
Coverage details in Maine
How many hours a week?
Individualized per treatment plan; MaineCare reimburses up to 120 hours a year of BCBA behavioral consultation
Private insurance has to help too
Not on Medicaid? Maine’s autism insurance law makes state-regulated private plans cover autism care — you’d pay your plan’s normal deductible and copays. The rule on the books: 2010 (LD 1198, effective 1/12/2011): originally age 10 and under with $36,000/yr cap; LD 2768 (2014) extended to under 21; federal parity renders caps unenforceable
Waiver programs worth knowing
Waivers can add services or open Medicaid eligibility even when family income is too high. In Maine: Section 21 (Comprehensive) and Section 29 (Supports) HCBS waivers for ID/ASD (mostly adults); Katie Beckett/TEFRA option for children's MaineCare eligibility
What does ABA actually cost in Maine?
Maine doesn't publish one simple, current hourly rate for ABA — payment runs through its own model behind the scenes. What matters for your wallet: with Medicaid, most families pay nothing out of pocket.
Maine questions, answered
Program rules change; this page describes Maine’s public coverage rules in plain English and isn’t legal or benefits advice. Send us your details and we’ll check your exact plan.
READY WHEN YOU ARE, MAINE.
“I’m worried, but there’s no diagnosis yet.”
That’s where most families begin. Tell us what you’re seeing and we’ll help you figure out the next step — even if it isn’t us.
Help me figure it out“We have a diagnosis. What does ABA cost?”
For most families it’s covered — Medicaid in every state, and every state has an autism insurance law. See exactly how yours works.
Check my state + insurance“I just want to talk to a person.”
One 15-minute call. A real human who does this every day, no pressure and no obligation.
Talk to a personBiggest cities in Maine
Local pages for Maine’s largest communities — what settings are realistically available in each, how far the nearest city is, and which county’s rules apply to you.
Counties we serve in Maine
Every corner of Maine — pick your county for local answers on coverage, in-home care, and how to start.
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