Since February 1, 2025, Medicaid ABA for children in a managed care plan is paid by that plan instead of the state, and AHCA's current coverage policy took effect February 10, 2025. Prior authorization now goes through the plan, and providers must be in its network. In 2026, the Legislature created a task force to review the program.
What changed in 2025?
Florida's Agency for Health Care Administration (AHCA) says that beginning February 1, 2025, behavior analysis services are paid by Statewide Medicaid Managed Care (SMMC) plans, so claims go to the child's plan. Children not enrolled in a plan stay on fee-for-service.
AHCA's current Behavior Analysis Coverage Policy, Rule 59G-4.125, took effect February 10, 2025.
- All behavior analysis services need prior authorization. The provider requests it from the child's plan, or from Acentra, AHCA's review contractor, if the child has no plan.
- A comprehensive diagnostic evaluation must go with the request.
- Medicaid covers eligible children under 21 who need medically necessary services.
What does that mean for my family?
If your child is in a plan, the ABA provider must be in that plan's network, and the plan can help you find one. When ABA moved to the plans, AHCA required them to honor existing ABA authorizations for at least 90 days, and each plan committed to up to 120 days (AHCA, April 2025). That transition period has ended.
A December 2024 legal-aid fact sheet says children keep the right to timely services, to continuity of care when they change plans or providers, and to appeal if services are denied, reduced or stopped.
Since 2025, ABA providers who want to keep serving their clients have had to negotiate contracts with the plans. In an April 17 letter to the plans, AHCA said that adding ABA to value-based contracts between plans and providers "has the potential to result in access issues" (WLRN/Florida Phoenix, August 2026).
What changed in 2026?
The Legislature created a 10-member ABA Task Force at AHCA. Its topics include limits on how long ABA is authorized and possible caps on the number of months a child can receive it. Its recommendations are due to the Governor and legislative leaders by December 31, 2026. As of October 21, 2026, it has not issued them, and no new limit or cap has been adopted. See our task force page for details.
Does Paramount Behavior accept Medicaid?
Paramount Behavior accepts Florida Medicaid and private insurance. In Palm Beach County we work with Molina Healthcare, Sunshine Health, Children's Medical Services Health Plan (CMS Health Plan) and Community Care Plan, and we are taking new families. Call (561) 421-0047 and we will check your child's plan for free, usually the same day. We also accept private insurance plans; call even if yours is not listed.
Do I need a new evaluation?
AHCA says a comprehensive diagnostic evaluation must go with prior authorization requests. One is typically enough for the treatment period, but the plan may ask for an update, for example if your child's condition changes or treatment lasts through more than one developmental phase.
Where can I call with problems?
AHCA lists the Medicaid helpline at 1-877-254-1055 for questions or problems getting services.
General information, not advice for your child. Medicaid rules change often; confirm with your child's plan or the AHCA Medicaid helpline at 1-877-254-1055.
Sources
- Behavior Analysis Services Information. Florida Agency for Health Care Administration (AHCA), accessed October 21, 2026.
- SMMC Program Highlight: Continuity of Care – Behavioral Analysis (BA) Providers. Florida Agency for Health Care Administration (AHCA), April 2025, accessed October 21, 2026.
- Applied Behavior Analysis (ABA) Task Force. Florida Agency for Health Care Administration (AHCA), accessed October 21, 2026.
- Important change to Behavior Analysis (BA) therapies for Medicaid-enrolled children. Florida Health Justice Project (fact sheet, December 2024), accessed October 21, 2026.
- Why does Florida spend so much money on treatment for children with autism and special needs?. WLRN / Florida Phoenix (2026-08-18), accessed October 21, 2026.