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Sproutwell ABA

ABA therapy in New Hampshire

New Hampshire 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.

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Does Medicaid cover ABA in New Hampshire? Yes.

THE COVERAGE PATHWAY

Covered for members under 21 as medically necessary under EPSDT (unbundled ABA codes since 5/1/2019); delivered through Medicaid Care Management MCOs — AmeriHealth Caritas NH, NH Healthy Families, and WellSense Health Plan

WHO RUNS IT

NH DHHS — Division of Medicaid Services (NH MMIS portal nhmmis.nh.gov; Provider Relations (866) 291-1674)

You don’t have to memorize any of this — we work with New Hampshire’s system every day.

Getting approved, in three steps

New Hampshire requires paperwork before therapy is covered. Here’s the whole process from your side of the table — we do the rest.

  1. 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. 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 New Hampshire — forms, follow-ups, and all.

  3. 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 (New Hampshire’s exact rules)

All ABA treatment requires service authorization from the member's MCO (InterQual criteria adopted 2026): ASD diagnostic evaluation plus a treatment plan covering direct treatment, supervision, and parent training components

Coverage details in New Hampshire

How many hours a week?

New Hampshire doesn't publish a fixed weekly-hours number. Hours are set child by child: your BCBA writes a treatment plan, and the reviewer approves the hours that plan supports. We'll tell you what to expect for your child on the first call.

Private insurance has to help too

Not on Medicaid? New Hampshire’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: Enacted 2010 (HB 569, "Connor's Law," effective 1/1/2011); covers ages 0-21; caps of $36,000/yr through age 12 and $27,000/yr ages 13-21 — dollar/age caps generally unenforceable under federal parity (MHPAEA)

Waiver programs worth knowing

Waivers can add services or open Medicaid eligibility even when family income is too high. In New Hampshire: In Home Supports Waiver for Children with Developmental Disabilities (ages 0-21); Developmental Disabilities Waiver; Home Care for Children with Severe Disabilities (Katie Beckett-type)

What does ABA actually cost in New Hampshire?

New Hampshire 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.

See New Hampshire costs

New Hampshire questions, answered

Program rules change; this page describes New Hampshire’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, NEW HAMPSHIRE.

“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.

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“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.

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Biggest cities in New Hampshire

Local pages for New Hampshire’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 New Hampshire

Every corner of New Hampshire — pick your county for local answers on coverage, in-home care, and how to start.

Looking for a different state?

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