ABA insurance and Medicaid coverage in Oregon

Last researched October 21, 2026

Who pays for ABA in Oregon, and what a practice has to do to bill them. Coverage details here come from statutes and agency pages we read, not from payer marketing.

Autism insurance mandate

Medium confidence: reputable secondary source

State mandate for autism coverage: Yes, the research found a state autism coverage law.
Statute: Oregon Laws 2013, chapter 771, section 2 (compiled as a note following ORS 743A.264, 'Temporary provisions relating to coverage of applied behavior analysis'); related general coverage in ORS 743A.190. Note: ORS 743A.325 is NOT the autism statute (it covers gender-affirming treatment).
Age limits: As of 2026-10-21, the provision applies to up to 25 hours per week of ABA when coverage is first requested before the individual is 9 years old (under nine years of age). Subsection (2)(b) also refers to beginning treatment before nine. Section 2(9) states that it does not limit coverage otherwise available under ORS 743A.168 or 743A.190, including ABA for more than 25 hours per week or ABA first requested at age 9 or older.
Annual cap: No annual dollar cap identified in the reviewed provision; 25 hours/week is not an overall ABA coverage ceiling.
Excludes self-funded employer plans: We could not verify this yet - check with your state insurance department.
Notes: ABA must be provided by a licensed health care professional (ORS 676.802), a behavior analyst or assistant behavior analyst licensed under ORS 676.810, or a behavior analysis interventionist registered under ORS 676.815 who receives ongoing training and supervision. Insurers may require prior authorization for up to 25 hours/week (decision within 30 calendar days) and an individualized treatment plan, updated no more than once every six months. The coverage section lists items not required to be covered under this particular provision, including services provided by family, IEP services, and 'telemedicine' as written in the compiled text; this exclusion describes this provision only, not all commercial coverage obligations (see ORS 743A.058). The section is scheduled to be repealed January 2, 2030 (Sec. 22, ch. 771, as amended). The ORS compilation read does not address self-funded plans, and their applicability remains unverified.

Sources (2)

Medicaid ABA coverage

Medium confidence: reputable secondary source

Medicaid covers ABA: Yes, per the sources below.
Program: Oregon Health Plan (OHP), delivered by coordinated care organizations for most members and by Oregon Health Authority fee-for-service (Open Card) for members not in a CCO
Agency: Oregon Health Authority, Health Systems Division (Medical Assistance Programs). Behavior-analysis licensure and technician registration are through the Health Licensing Office, Behavior Analysis Regulatory Board.
Provider enrollment: https://www.oregon.gov/oha/HSD/OHP/Pages/Provider-Enroll.aspx

Sources (15)

Payers named in our research

We could not verify named payers for Oregon yet - check with the state Medicaid agency.

How to enroll

Start at the state Medicaid provider enrollment page: https://www.oregon.gov/oha/HSD/OHP/Pages/Provider-Enroll.aspx.
Ask each commercial payer you want to bill for its credentialing application and timeline. We have not verified payer timelines.
Confirm which staff types the payer reimburses, including whether technicians must hold the RBT credential. See BT vs RBT in Oregon.

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