The Centers for Medicare & Medicaid Services (CMS) released an Autism Spectrum Disorder (ASD) and Applied Behavior Analysis (ABA) Data Book. This data helped inform CMS’ State Medicaid & Children’s Health Insurance Program (CHIP) Applied Behavior Analysis toolkit that was released on August 4th. ABA therapy is an evidence-based therapy that applies principles of learning and behavior to help individuals with ASD and other neurodevelopmental disorders gain functional skills and improve adaptive behaviors. Medicaid and CHIP programs have seen rapid growth in both utilization and spending on ABA therapy in recent years.
CMS sought to better understand the drivers of this growth by conducting detailed analyses of T-MSIS Analytic Files (TAF) to investigate National and State-Level ABA cost and utilization trends from 2021-2025 across all Medicaid and CHIP fee-for-service (FFS) claims and managed care encounters. The results of this investigation are presented in seven sections in this Data Book.
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