Advocates: 44 West Virginia Counties Have No ABA Clinic. At Only $9.90 a Unit, It Is No Surprise

CHARLESTON, WEST VIRGINIA – Forty-four of West Virginia’s 55 counties have no ABA services clinic, according to the Mountaineer Autism Project, an advocacy nonprofit founded in 2010, which estimates that about 400 of the state’s more than 11,000 children with autism receive the therapy. The state’s Medicaid program pays $9.90 for 15 minutes of a behavior technician’s time with a child.

On September 29, the project and We Develop ABA, a 13-member coalition it leads with Augusta Levy Learning Center and Bright Futures Learning Services, demanded that the state release a study of its ABA rates and raise the rate. Susannah Poe, the project’s board president, said providers learned earlier this year that the Bureau for Medical Services, the state’s Medicaid agency, had begun studying the rates after several years without a review and now has findings it has not released. The Department of Human Services, which oversees the bureau, did not respond to West Virginia Public Broadcasting’s request for comment.

About 46% of West Virginia children had Medicaid coverage in 2024, compared with about 37% nationally, according to KFF’s analysis of Census survey data. “There are roughly 20 ABA centers in our state, and less than half of them will take Medicaid payments, which is an enormous barrier in a state like West Virginia,” said Poe, a professor emerita at the West Virginia University School of Medicine.

How West Virginia’s Rate Compares

West Virginia Medicaid’s ABA policy covers members from 18 months through age 20 whose primary autism diagnosis was made before age 8 and who are referred through EPSDT, Medicaid’s screening benefit for children. Every ABA service needs prior authorization; the covered codes together are capped at 40 hours a week and eight hours in any 24-hour period, and payment follows the bureau’s fee schedule. That schedule lists $9.90 per 15-minute unit for the technician code, CPT 97153, and gives April 1, 2021, as the code’s effective date; it does not say when the fee itself was last changed. That is $39.60 for an hour of one-on-one session time.

At its September 29 briefing, the project called West Virginia’s rate the lowest in the nation. Kentucky and Maryland, two of West Virginia’s five neighbors, pay more for the same technician unit: Kentucky $12.18 under a schedule that took effect April 1, 2026, and Maryland $19.17 when a technician delivers the session and $24.41 when a BCBA does, under its February 2026 ABA manual. Two days after the briefing, on October 1, New York cut its fee-for-service rate for technician-delivered sessions to $9.63 per 15-minute unit, below West Virginia’s listed $9.90. The West Virginia, Kentucky, and Maryland figures come from official fee schedules; the New York figure comes from an August 2026 New York State Medicaid Update announcing the October 1 change.

“The barrier that we have is reimbursement for services,” Poe said. Nathel Lewis, executive director of children and youth services at Diversified Assessment and Therapy Services, a coalition member, said the rate has to stretch beyond a technician’s paycheck to keep staff trained, credentialed, supervised, and employed, the Bluefield Daily Telegraph reported. “It’s about whether West Virginia wants to build the capacity to care for its own children,” he said.

Workforce Shortages and Waiting Lists

The Behavior Analyst Certification Board’s live regional table listed 182 BCBAs and 20 BCBA-Ds in West Virginia, for a combined total of 202, when accessed October 5, 2026. The project said at its September 29 briefing that the state’s ratio of analysts to residents is the sixth-lowest in the country, as West Virginia Watch and WAJR reported. Poe told WAJR in May that graduates of the behavior analysis programs at West Virginia University, Marshall University, and Martinsburg College often take jobs out of state; the coalition launched a recruiting campaign that month. “Our resources have been going out of state when we need to keep them in state,” she said.

Lewis told WCHS-TV in Charleston that many of the state’s ABA centers are “small West Virginia owned companies” whose expansion is “hindered because we do not have the qualified therapists or board-certified behavior analyst specific to ABA centers to be able to get these kids off our waitlist.”

Poe also told WAJR in May that about 2,000 to 3,000 children were on waiting lists for services. Four of the state’s 10 most populous counties have no ABA services clinic, according to the project’s current campaign page. Ranzi Stacy, a Bridgeport mother of two autistic children who works as a service coordinator for West Virginia Birth to Three, the state’s early intervention program, said her children waited nearly two years for an opening. “There is no worse feeling as a parent than knowing your child needs help and not being able to get it,” she said.

“ABA may be covered on paper, but if a family can’t find a provider who can take their child, that coverage doesn’t mean very much.” – Jenna Wallace, Co-owner, Unlocked Potential (2026)

Jenna Wallace, a licensed pediatric clinical psychologist who co-owns Unlocked Potential in Fairmont, also spoke at the September 29 briefing. “ABA may be covered on paper, but if a family can’t find a provider who can take their child, that coverage doesn’t mean very much,” she said. “When children can’t get services early, their needs only grow as they get bigger and older.”

A Rate Study the State Has Not Released

The coalition’s formal asks are three: complete and release the rate study, raise the rates so clinics can pay competitive wages and keep qualified staff, and build a long-term workforce plan with providers, families, and legislators. “We understand they have those findings; they have not released them,” Poe said. “We ask them to release them now and start a conversation.”

The coalition said it wants to work with the bureau, the Department of Human Services, and legislators ahead of the 2027 session. The Legislature convenes January 13 at noon.

AT A GLANCE

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