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Illinois Medicaid and ABA therapy

Yes. Illinois Medicaid has covered ABA for children with autism since November 1, 2020, in both fee-for-service and managed care plans. HFS calls it Adaptive Behavior Support (ABS).

  • 6Medicaid plans with a directory
  • $13per 15 minutes, code 97153 (2026)
  • 163ABA providers in our Illinois cities

At 40 hours a week, Illinois Medicaid's technician rate comes to $2,080 of billed ABA, the 5th highest of the 6 states on this list (North Carolina: $3,329.60). Source: Illinois Department of Healthcare and Family Services fee schedule (2026) and North Carolina's (2026).

Filling in a Illinois Medicaid application form at a kitchen table

How to get ABA therapy through Illinois Medicaid

  1. Get the diagnosis. A child needs an autism diagnosis and a doctor's order for ABA. The first request must include a full diagnostic evaluation by a physician or clinical psychologist using a test such as ADOS, GARS, ADI or CARS. If that evaluation is more than 24 months old, a current note on the child's needs is also required. Source: Illinois Department of Healthcare and Family Services [2].
  2. Find a provider that takes your plan. Use the list for your city, then check the plan's own directory below.
  3. The provider asks for approval. All ABA treatment needs prior approval. Assessment needs approval only if it goes over 6 hours in 180 days. The doctor's order is good for one year, and the treatment plan must be updated every 180 days. Managed care plans set their own approval steps. Source: Illinois Department of Healthcare and Family Services.
  4. Hours are set by need. Hours are based on medical necessity. The state fee schedule allows up to 32 units (8 hours) of 97153 per day. Source: Illinois Department of Healthcare and Family Services.

The rules in Illinois

Programme
Illinois Medicaid (HFS medical card). Most members get care through a HealthChoice Illinois managed care plan. Source: Illinois Client Enrollment Services (HFS).
Age limit
Children and young adults from birth through age 20. Source: Illinois Department of Healthcare and Family Services.
Who can provide it?
HFS-enrolled Board Certified Behavior Analysts (BCBAs) and Registered Behavior Technicians (RBTs). A BCBA may supervise up to 8 RBTs and must directly supervise at least 5% of each RBT's hours each month. Source: Illinois Department of Healthcare and Family Services [2].
How long approval takes
For fee-for-service Medicaid, the state decides prior approval requests within 30 days. The clock stops if paperwork is missing. Source: Illinois Department of Healthcare and Family Services.
What Medicaid pays
$13 per 15 minutes for technician-delivered ABA (97153), 2026 schedule. $20.39 per 15 minutes when the analyst adjusts the plan (97155). Source: Illinois Department of Healthcare and Family Services [2].
Official page
Adaptive Behavior Support Services (Illinois HFS) Source: Illinois Department of Healthcare and Family Services.

Medicaid plans in Illinois and their provider directories

Most children on Illinois Medicaid are in a managed care plan. ABA providers must be in your plan's network, so search the plan's own directory for "applied behavior analysis".

The state's own Medicaid provider search Source: Illinois Client Enrollment Services (HFS).

ABA therapy that accepts Medicaid in Illinois, by city

The public register doesn't record which plans a provider takes, so every list below shows all registered ABA providers. Ask each one the same thing: "Are you in network with my Medicaid plan?"