Insurance · Ohio Medicaid

Ohio Medicaid covers ABA therapy. We handle the paperwork.

Ohio Medicaid pays for Applied Behavior Analysis when your child has an autism diagnosis — through every managed care plan, MyCare Ohio, and fee-for-service. We verify benefits, request prior authorization, and walk your family through every step.

Check My Medicaid Benefits Call (614) 681-1030
$0
Copay for Medicaid families
All
Ohio MCO plans in-network
72hr
Typical start-of-care window
Status
Approved
Plan
Buckeye / Molina / CareSource
The Autism Spectrum Disorder Benefit

ABA is a covered Medicaid benefit in Ohio.

The Ohio Department of Medicaid (ODM) covers Applied Behavior Analysis under the Autism Spectrum Disorder (ASD) benefit. As long as your child has a current autism diagnosis from a licensed provider and a medical-necessity recommendation, ABA is covered — with no annual hour cap and no family copay.

Diagnosis required

A formal autism diagnosis — from a licensed psychologist, developmental pediatrician, or qualified BCBA evaluator — is the first step. If you do not have one yet, we can help you get evaluated.

Treatment plan & prior auth

A BCBA writes the treatment plan and submits it to your managed care plan for prior authorization. Most plans respond within 14 days. We file every page.

Hours that match your child

Ohio Medicaid authorizes the hours your BCBA recommends — whether that is 10 hours a week of focused care or 30+ hours of comprehensive early intervention.

No copay, no deductible

Ohio Medicaid families pay nothing out of pocket for covered ABA hours. No copay, no coinsurance, no per-session bill.

Ages 0 through 20

Ohio Medicaid covers ABA from infancy through age 20 under the EPSDT benefit. There is no “too young” or “too old” if the medical necessity is documented.

Center, home, or both

Coverage applies whether your child receives ABA in our Mayfield Village, Gahanna, or Worthington centers — or at home in the Columbus / Cleveland metro area.

Qualifying for Ohio Medicaid ABA

Three things your family needs.

Most families assume Medicaid is complicated. For ABA in Ohio, the requirements are simple — and we walk you through each one.

Start with a free benefits check
1

Active Ohio Medicaid coverage

Your child is enrolled in Ohio Medicaid — either fee-for-service or through one of the seven managed care plans: Buckeye Health Plan, CareSource, Molina, AmeriHealth Caritas, Anthem Blue Cross Blue Shield, Humana Healthy Horizons, or UnitedHealthcare Community Plan. All seven cover ABA the same way.

2

An autism diagnosis on file

Your child has been formally diagnosed with Autism Spectrum Disorder by a qualified licensed clinician. If your child has not been tested yet, we provide diagnostic evaluations at our Ohio centers — usually scheduled within a week.

3

A medical-necessity recommendation

A BCBA assesses your child and writes a treatment plan that explains the recommended hours, goals, and setting. This is the document Medicaid reviews when issuing prior authorization. We complete this at no cost to your family.

Plan-by-Plan

Every Ohio Medicaid plan we accept & bill.

On Target ABA is in-network with all of Ohio’s managed care plans plus MyCare Ohio. You should never have to switch plans to start therapy with us.

Managed Care Plan

Buckeye Health Plan

Centene-owned MCO. Prior auth via the Centene provider portal. Typical turnaround 7–14 days.

Managed Care Plan

CareSource

Dayton-based and Ohio’s largest Medicaid MCO. Authorizations route through their Behavioral Health team.

Managed Care Plan

Molina Healthcare

Routes ABA prior auth through Magellan Healthcare. We have a dedicated contact for fast turnaround.

Managed Care Plan

AmeriHealth Caritas Ohio

Newer to Ohio’s MCO program. Coverage mirrors the ODM rule — ABA covered with the same medical-necessity standard.

Managed Care Plan

Anthem BCBS Medicaid

Anthem’s Ohio Medicaid line of business. Same Carelon Behavioral Health utilization review as their commercial plans.

Managed Care Plan

Humana Healthy Horizons

Humana’s Ohio Medicaid plan. Prior authorization required for ongoing ABA past the initial assessment.

Managed Care Plan

UnitedHealthcare Community

UHC’s Ohio Medicaid plan. Optum Behavioral Health manages utilization. We are credentialed and accepting new families.

Dual-Eligible

MyCare Ohio

For children who qualify for both Medicaid and Medicare. ABA is still covered — the MCO portion of MyCare handles the authorization the same way as a standard plan.

No MCO

Fee-for-Service Medicaid

Some children, including newborns awaiting MCO assignment and certain waiver kids, are on straight ODM fee-for-service. ABA is covered — we bill ODM directly.

What Happens Next

From your first call to your child’s first session.

Most Ohio Medicaid families start care within 2–4 weeks. Here is exactly what we handle for you, in order.

  1. 01

    Benefits verification

    You give us your child’s Medicaid ID and MCO. We confirm coverage and pull authorization requirements within 24 hours.

  2. 02

    Diagnostic evaluation (if needed)

    If your child does not yet have an autism diagnosis, we schedule one at our Ohio center — usually within a week.

  3. 03

    BCBA assessment & plan

    Our BCBA meets your family, observes your child, and writes the treatment plan and recommended hours.

  4. 04

    Prior authorization & start

    We file with your MCO. Once approved, we schedule your child’s first session — in-center or in-home.

Need help paying for autism testing first?

If your child does not have a diagnosis yet and you are worried about cost, Ohio also offers the Jon Peterson Special Needs Scholarship and Autism Scholarship Program for school-age children. We can help you figure out which path makes sense.

Learn about the Ohio Autism Scholarship
Quality care without the wait

We do every form, every code, every call.

Families come to us tired from being on a waitlist somewhere else. Once you call, the paperwork is our job — not yours. You focus on your child.

Get my child started Call (614) 681-1030
Frequently Asked

Ohio Medicaid & ABA — straight answers.

Does Ohio Medicaid actually cover ABA, or just “sometimes”?

Yes — Ohio Medicaid covers ABA therapy for any child enrolled in Medicaid who has an autism diagnosis and a medical-necessity recommendation. This is true for every managed care plan (CareSource, Buckeye, Molina, AmeriHealth, Anthem, Humana, UnitedHealthcare) and for fee-for-service Medicaid. There is no annual hour cap and no copay.

What if my child has not been diagnosed with autism yet?

Start with the evaluation. Ohio Medicaid covers diagnostic testing too, and we conduct evaluations at our Mayfield Village, Gahanna, and Worthington centers — usually within a week. Once your child has a diagnosis, we move straight into the BCBA assessment for ABA.

How many hours of ABA will Medicaid approve?

Whatever the BCBA recommends as medically necessary. For early-intervention-age children (under 6), that is often 25–40 hours a week of comprehensive care. For school-age children, it is typically 10–20 hours of focused care after school. Ohio MCOs review the plan and authorize the hours that match your child’s needs — not a flat number.

My child has both Medicaid and private insurance. Which one pays?

Private insurance bills first, Medicaid bills second. You still pay $0. Medicaid is “the payer of last resort,” so any copay, coinsurance, or deductible left over from your commercial plan gets picked up by Medicaid — not by your family. We coordinate both behind the scenes.

What is MyCare Ohio and how does it relate to ABA?

MyCare Ohio is the state’s integrated program for people who qualify for both Medicaid and Medicare. Children rarely have both, but it happens — usually through a disability category. Under MyCare, ABA is still covered. The Medicaid portion of the MyCare plan handles the authorization the same way a regular MCO would. We are credentialed with the MyCare plans operating in Cuyahoga and Franklin counties.

What Ohio families say
“My twins are currently attending one of the centers. We have had an amazing experience with On Target, especially the airport location. 5 stars all around…”

— Zi Zi World Tarpeh, Columbus / Gahanna

“Beautifully renovated. Fresh and clean. Attentive, experienced staff. Always a pleasure to go there!”

— Ruchie Kaplan, Cleveland / Mayfield Village

Ready when you are

Let’s get your child in care this month.

Ohio Medicaid pays. We do the paperwork. You get your weeks back. Call us or send your info and we will take it from there.

Start with a free benefits check Call (614) 681-1030

Mon–Fri, 8:00 AM – 5:00 PM