What the bulletin provides
Indiana Health Coverage Programs bulletin BT202627, dated February 26, 2026, changes the state's ABA benefit. ABA is covered only through EPSDT, which serves Medicaid eligible people under 21. Members 21 and older who were already receiving ABA could continue when medically necessary during a transition window from April 1 through September 30, 2026. For dates of service on or after October 1, 2026, the program will no longer authorize or reimburse ABA for those members.
Rates and hour limits
The bulletin sets a maximum fee reduction of 6% for nongroup ABA services for dates of service on or after April 1, 2026. A further 4% reduction applies to all ABA procedure codes, including group services, for dates of service on or after April 1, 2027. For dates of service on or after April 1, 2026, eligible members may receive up to 4,000 hours (16,000 units) of comprehensive ABA over their lifetime, based on medical necessity. After that allocation is used, up to 15 hours per week of targeted ABA may be covered, and further comprehensive therapy may be covered under EPSDT if a later review finds it medically necessary. School corporation services are excluded from these changes.
What we have not verified
We read the bulletin itself. We have not reviewed the state plan amendment behind it, and we have not seen how the program has handled individual members at the October 1 cutoff.
Why it matters to an operator
Analysis: The age 21 date has now arrived under the bulletin's terms, so an Indiana practice with adult clients should confirm what happens to each of those files and each open claim, and should not assume any authorization continues. The lifetime hour limit also means each client's cumulative hours matter, so a practice needs a reliable running count of comprehensive hours for every Indiana member.
If your Indiana clients include members 21 and older, the payer and Medicaid advisory works through the caseload, the billing and the transition risk with you, alongside your counsel.
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This brief rests on the primary source linked above. Education only; nothing here is legal advice.
ABAWiser provides research, analysis, and compliance advisory services. We are not a law firm, we do not provide legal advice, and no engagement creates an attorney client relationship. Dossiers track developments as they occur and may be incomplete or updated as a story evolves. Confirm any statutory or regulatory point against the primary source before acting on it.