Insurance Guide · Pennsylvania (PA)
ABA Therapy Insurance in Pennsylvania
Annual Cap
$36,000 per year
Age Limit
Through age 21
Plan Types
Individual and group fully-insured plans
Pennsylvania Mandate Details
Mandate Law
Act 62 (2008)
Year Enacted
2008
Medicaid Coverage in Pennsylvania
Pennsylvania Medicaid covers ABA through the Intensive Behavioral Health Services (IBHS) program for children under 21.
What to Know About ABA Coverage in Pennsylvania
Pennsylvania's Act 62 caps commercial ABA coverage at $36,000 per year through age 21. The state's IBHS Medicaid program is one of the most developed ABA Medicaid frameworks in the country.
Frequently Asked Questions
What is Pennsylvania's annual cap for ABA insurance coverage?
Pennsylvania caps ABA insurance coverage at $36,000 per year through age 21 for individuals with autism on fully-insured plans under Act 62.
What is Pennsylvania's IBHS program?
Intensive Behavioral Health Services (IBHS) is Pennsylvania Medicaid's framework for ABA coverage. It provides comprehensive ABA services for children under 21 and is one of the most developed Medicaid ABA programs nationally.
Is $36,000 enough for ABA therapy in Pennsylvania?
At Pennsylvania's rates, $36,000 covers approximately 12-18 hours per week. Families needing intensive programs often combine commercial insurance with IBHS (Medicaid) coverage to access more hours.
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Need help navigating ABA insurance?
Our team works with ABA providers across Pennsylvania.