Medicaid Tightens Autism Therapy Oversight as Spending Hits $10 Billion
Updated
Updated · The New York Times · Aug 4
Medicaid Tightens Autism Therapy Oversight as Spending Hits $10 Billion
1 articles · Updated · The New York Times · Aug 4
Summary
A 173-page federal Medicaid toolbox due Tuesday tells states to impose tighter controls on autism therapy providers, including billing limits, prior authorization for high-hour treatment and stronger outcome tracking.
Medicaid officials said the guidance responds to a sharp cost surge and concerns that profit-driven clinics exploited coverage mandates through wasteful or fraudulent practices.
Spending on autism therapy reached $10 billion in 2025, up fivefold from about $2 billion in 2021, while median spending per child rose to $21,203 from $8,903.
Thousands of clinics have expanded with limited oversight, and workers told The New York Times some providers overprescribed therapy hours and urged families to pull children from school to maximize revenue.