A plain-language guide to paying for autism therapy in Texas: insurance, Medicaid, MBIC, TRICARE, waivers, SSI, school funding, ABLE accounts and grants.
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The short answer: Texas families have more ways to pay for autism therapy than most people realize. The main ones are private insurance (Texas law requires many plans to cover autism services, including ABA), Texas Medicaid (which has covered ABA for children since February 2022), Medicaid Buy-In for Children for families who earn too much for regular Medicaid, TRICARE for military families, and a handful of state programs and private grants. Some of these have waiting lists measured in years, so it pays to sign up early, even if your child is very young.
If you're sorting through this late at night after a long day, you're not behind. Most families learn this system one piece at a time. This guide puts the pieces in one place, in the order most families need them.
Texas has an autism insurance law (Texas Insurance Code, Chapter 1355). For plans it applies to, it requires coverage of generally recognized autism services prescribed by your child's primary care physician, including evaluation, ABA therapy, speech therapy, occupational therapy, physical therapy and medications.
What to do: ask your HR team one question: "Is our health plan fully insured or self-funded?" Then call the number on your insurance card and ask whether ABA, speech and occupational therapy are covered for autism, and whether you need a referral or prior authorization.
Texas Medicaid covers ABA for children and young adults age 20 and younger with an autism diagnosis. This benefit started February 1, 2022. It's provided by Licensed Behavior Analysts at home, in the community or in a center. Medicaid also covers speech therapy, occupational therapy, physical therapy and Early Childhood Intervention (ECI).
CHIP does not cover ABA in Texas. It does cover speech therapy, occupational therapy and behavioral health. If your child has CHIP and needs ABA, look at Medicaid Buy-In for Children and the HHS Children's Autism Program below.
MBIC lets families who earn too much for regular Medicaid buy Medicaid coverage for a child with a disability, for a monthly premium on a sliding scale. It can also sit alongside employer insurance as a second layer of coverage.
TRICARE covers ABA through the Autism Care Demonstration, which is authorized through December 31, 2028. It's open to children of active-duty service members, retirees and some Guard and Reserve members. Families pay their normal TRICARE copays, with no annual or lifetime cap on covered ABA.
Texas Health and Human Services funds focused ABA therapy through local contracted providers for children ages 3 through 15 with an autism diagnosis. Services are capped at 180 hours in a 12-month period and 720 hours in a lifetime. It's a good option to know about if your insurance doesn't cover ABA. Call 2-1-1 or the program office at 512-438-5356 to find the nearest contractor.
Texas offers long-term support programs called Medicaid waivers. They can pay for things like respite, therapies, adaptive aids and in-home support. The catch is the wait: interest lists can run for many years. Families are served in the order they signed up, so the most useful thing you can do is add your child's name as early as possible. It's free, and you can decline later.
Each program has its own eligibility rules, and an autism diagnosis alone doesn't guarantee a child qualifies. Signing up holds your place in line while that gets sorted out.
Supplemental Security Income (SSI) pays a monthly benefit to children under 18 with a qualifying disability whose families have limited income and resources. Social Security counts part of the parents' income and resources when deciding eligibility. The maximum federal payment in 2026 is $994 a month. In Texas, a child who gets SSI usually also qualifies for Medicaid. Apply at ssa.gov or call 1-800-772-1213.
A Texas ABLE account lets families save for disability-related expenses with tax advantages, without affecting most public benefits. Balances up to $100,000 don't count against SSI. Anyone whose disability began before age 46 can have one, and family and friends can contribute up to $20,000 a year in total. Learn more at texasable.org or call 844-489-2253.
Caring for a child with high support needs is a lot to carry. Take Time Texas is a free statewide directory from Texas HHS for finding respite providers by location, age and type of care. Your local Area Agency on Aging (1-800-252-9240) can also tell you about respite help through the Texas Lifespan Respite Care Program.
These organizations offer grants that Texas families can apply for. Each has its own rules and funding cycles, and grants are limited, so apply to more than one if your family qualifies.
Our Texas centers check your benefits before your child's first visit, so you know what's covered before you commit. In Texas we accept Aetna, BCBS of Texas, TRICARE, UnitedHealthcare and United Behavioral Health.
If your child is under 3, read our guide to ECI in Texas, too. For more on how insurance covers ABA, see Is ABA covered by insurance?
Often, yes. Texas law requires fully insured and state-regulated plans to cover autism services, including ABA, for children diagnosed before age 10. Self-funded employer plans aren't covered by that law, but many of them cover ABA anyway. Texas Medicaid covers ABA for members 20 and younger, and TRICARE covers it through the Autism Care Demonstration.
Yes. Medicaid Buy-In for Children lets families with incomes up to 300% of the federal poverty level buy Medicaid coverage for a child with a disability. Medicaid waiver programs are another route, though they have long interest lists.
Yes. Waiting times can run many years and places are given in sign-up order. Signing up is free and doesn't commit you to anything.
Yes. ACT Today!, the UnitedHealthcare Children's Foundation and Variety – the Children's Charity of Texas all offer grants that can help pay for therapy. Funding is limited and each has its own eligibility rules and application cycles.
Program details change, so confirm amounts and deadlines with each program before you apply. Sources: Texas Health and Human Services (Medicaid ABA, Medicaid Buy-In for Children, Children's Autism Program, interest lists, Take Time Texas); Texas Insurance Code Chapter 1355; TRICARE; Social Security Administration; Texas Education Agency and SPEDTex; Texas Comptroller; Texas ABLE; each grant organization's website. Last checked October 2026.
Our Texas team checks your benefits before your child's first visit, so you know what's covered before you commit. We accept Aetna, BCBS of Texas, TRICARE, UnitedHealthcare and United Behavioral Health.
One call is enough to start. Call 817-984-8655 and we'll check your benefits for you.
Gracent Pediatric Therapy — formerly Pine Cone Therapies in Texas and includes three North Shore Pediatric Therapy centers in Illinois — is part of the Gracent network and a sister company to North Shore Pediatric Therapy. Together, we’re creating connected, compassionate care for children and families across every stage of growth.
Services at North Shore Pediatric Therapy and Gracent Pediatric Therapy centers are provided by affiliated professional corporations.
