By: dfitzgerald
Q&A: CMS Guidance on EPSDT Services for Children with ASD in Medicaid
![](https://healthlaw.org/wp-content/uploads/2018/09/img_1422492886.png)
Q&A: CMS Guidance on EPSDT Services for Children with ASD in Medicaid
![](https://healthlaw.org/wp-content/uploads/2018/09/img_1422492886.png)
Executive Summary
Under longstanding Medicaid law, the state Medicaid agency must cover particular treatments “including intensive behavioral services” if they are coverable Medicaid services, necessary to correct or ameliorate a child’s ASD, and no alternative, equally effective treatment is appropriate for the child. A recent CMS guidance letter and FAQ discuss coverage of services for children with ASD. They do not require states to cover ABA therapy per se; however, they suggest that, if the state does not cover ABA therapy under EPSDT, it must cover comparable services that are expected to achieve comparable outcomes.