The text read is the CMS approval package for SPA TN WY 24-0005 (CMS, SPA TN WY 24-0005, approval letter dated October 31, 2024). Every Wyoming Department of Health URL tried returned HTTP 403, so the fee schedules, provider manual, and the April 2024 public notice could not be read. No later Wyoming ABA amendment was searched for.
Wyoming's fee schedule, provider manual, and hour limits were not reachable. This page describes the approved state plan amendment and nothing else. Treat rates, settings, authorization specifics, and enrollment steps as unconfirmed.
The reimbursement criteria at a glance
- Is ABA covered by Wyoming Medicaid
- Who is eligible
- Covered services and rates
- Settings
- Prior authorization
- Provider qualifications
- The commercial mandate
- Practices with in-house diagnostics versus ABA-only practices
- How this connects to the rest of your compliance stack
- What this guide could not verify
- Wyoming reimbursement variables at a glance
- Frequently asked questions
- Where professional advice is essential
Is ABA covered by Wyoming Medicaid
Yes. The amendment "moves the Applied Behavior Analysis (ABA) services from the Rehabilitative Services, Mental Health and Substance Abuse section to the Preventive Services Section of the plan with a reference in the Early Periodic Screening Diagnosis and Treatment (EPSDT) services to Preventive services." CMS approved it "on October 31, 2024, with an effective date of July 1, 2024" (CMS, SPA TN WY 24-0005).
Who is eligible
"Applied Behavior Analysis (ABA) treatments are allowable to children between the ages of 0-20 years of age with a diagnosis of Autism Spectrum Disorder" (CMS, SPA TN WY 24-0005). Who may diagnose and refer was not verified.
Covered services and rates
The plan lists the allowable services: behavior identification assessment, behavioral identification supporting assessment, adaptive behavior treatment, and family adaptive behavior treatment guidance (CMS, SPA TN WY 24-0005). The plan pages read give no codes or rates, and no fee schedule was found.
Settings
The plan says that for expanded EPSDT services, "a prior authorization process will determine the medical necessity and most cost effective setting for the service" (CMS, SPA TN WY 24-0005). Specific home, community, school, and telehealth rules were not verified.
Prior authorization
"Any limits on services or treatments are not applicable to EPSDT recipients if the service is determined to be medically necessary as a result of an EPSDT referral and is prior authorized" (CMS, SPA TN WY 24-0005). Who reviews authorizations, any hour limits, and any managed care involvement were not verified.
Provider qualifications
Licensed and certified practitioners include the "Board Certified Behavior Analyst - Doctoral" and the "Board Certified Behavior Analyst" as defined by the BACB. ABA treatments "are also covered for certain practitioners (acting within the scope of their licensure or certification) when they are supervised by" a BCBA-D or BCBA, including a BCaBA and a Registered Behavior Technician, for adaptive behavior treatment only (CMS, SPA TN WY 24-0005). Enrollment steps and whether Wyoming state licensure is required in addition to BACB certification were not verified. See the Wyoming Licensing page.
The commercial mandate
Wyoming's commercial autism coverage was not verified. Search results pointed only to secondary summaries of a 2019 Department of Insurance bulletin, and no official copy or statute was found.
Practices with in-house diagnostics versus ABA-only practices
The plan text read does not say who diagnoses or refers beyond an EPSDT referral, so the archetype split could not be verified for Wyoming.
How this connects to the rest of your compliance stack
See the Wyoming Licensing page for the credential posture and the Wyoming entity page for the structure analysis.
What this guide could not verify
- Per-unit rates and any fee schedule.
- Home, community, school, and telehealth rules.
- Who reviews prior authorization, hour limits, and any managed care involvement.
- Medicaid enrollment steps and any state licensure requirement.
- The commercial autism coverage requirement.
Wyoming reimbursement variables at a glance
| Variable | Wyoming value |
|---|---|
| ABA covered by Medicaid? | Yes, SPA TN WY 24-0005, effective July 1, 2024 |
| Ages | 0 to 20 with an ASD diagnosis |
| Practitioners | BCBA-D and BCBA; BCaBA and RBT under supervision for adaptive behavior treatment |
| Rates | Not verified |
| Commercial mandate | Not verified |
Frequently asked questions
When did Wyoming move ABA to Preventive Services?
Who can provide ABA?
Where professional advice is essential, not optional
Wyoming is a thin page, resting on one state plan amendment. Get the fee schedule and provider manual from the Department of Health before you commit to a Wyoming build.
The governing authority to know is SPA TN WY 24-0005.
This page describes rules read from a CMS state plan approval package. Wyoming Department of Health pages could not be read. The Department of Health, the Department of Insurance, and each payor provide current requirements. Do not rely on this page or any secondary source in place of direct verification.