CHARLESTON, WEST VIRGINIA – The state’s Medicaid program pays $9.90 for each 15-minute unit of one-on-one ABA delivered by a technician, or $39.60 an hour, according to its published fee schedule, which lists April 1, 2021 as the code’s effective date. The Mountaineer Autism Project, a West Virginia autism advocacy nonprofit, calls it the lowest in the country for the ABA service children receive most often. On Tuesday, September 29, the group asked the Bureau for Medical Services, the state’s Medicaid agency, to complete and release a Medicaid rate study on ABA and to raise the rates, West Virginia Watch reported from the group’s news release.
Fewer than half of the state’s roughly 20 ABA centers accept Medicaid, the group said, calling the rate a barrier to care. About 46% of the state’s children had Medicaid or related public coverage in 2024, according to KFF’s analysis of Census survey data. Ranzi Stacy, a Bridgeport mother and service coordinator with West Virginia Birth to Three, the state’s early-intervention program, said her children spent nearly two years on waiting lists before an ABA opening came. “There is no worse feeling as a parent than knowing your child needs help and not being able to get it,” she said. Susannah Poe, the group’s board president, told WAJR in May that about 2,000 to 3,000 children were on waiting lists for services.
West Virginia has 186 BCBAs, or 10.5 per 100,000 residents, the sixth-lowest ratio in the country, West Virginia Watch reported on September 29. Higher rates, the group said, would let providers “offer competitive wages, hire and retain qualified staff, and expand services for children covered by Medicaid.”
New York’s Medicaid fee-for-service program will pay $9.63 per 15-minute unit for the same technician-delivered service starting October 1, according to the state health department’s August Medicaid Update. That is 27 cents less than West Virginia’s listed $9.90.
“We want to work with state leaders on solutions,” Poe said. The state has “thousands of families who need care, providers who want to serve more children and people who can be trained for these jobs,” she said, and getting reimbursement right would bring the three together. The bureau, which sets the rates, is not quoted in the report. The Legislature’s 2027 regular session opens January 13.
AT A GLANCE
| West Virginia Medicaid rate, CPT 97153: | $9.90 per 15-minute unit of technician-delivered ABA ($39.60 per hour); code effective date listed as April 1, 2021 (Bureau for Medical Services fee schedule, accessed September 29, 2026) |
| Centers accepting Medicaid: | Fewer than half of roughly 20 ABA centers in the state (Mountaineer Autism Project news release, September 29, 2026, as reported by West Virginia Watch) |
| New York, same service: | $9.63 per 15-minute unit under Medicaid fee-for-service, effective October 1, 2026 (New York State Department of Health Medicaid Update, August 2026) |
| What the group asked: | The Bureau for Medical Services to complete and release a Medicaid rate study on ABA and raise the rates (West Virginia Watch, September 29, 2026) |
SOURCES & REFERENCES
| 1. | Knisely AF. “Children with autism struggling to access therapy; advocates call on WV leaders to address Medicaid.” West Virginia Watch. September 29, 2026. https://westvirginiawatch.com/2026/09/29/children-with-autism-struggling-to-access-therapy-advocates-call-on-wv-leaders-to-address-medicaid/ |
| 2. | West Virginia Bureau for Medical Services. Applied Behavior Analysis Fee Schedule (Contracts & Codes for: ABA – Medicaid). Accessed September 29, 2026. https://bms.wv.gov/media/39954/download?inline |
| 3. | West Virginia Bureau for Medical Services. Medicaid Provider Manual, Chapter 519.23, Applied Behavior Analysis. Effective April 1, 2020. https://bms.wv.gov/media/40119/download?inline= |
| 4. | Mountaineer Autism Project. “We Develop ABA” statement (homepage) and “History.” Accessed September 29, 2026. https://mountaineerautismproject.com/ and https://mountaineerautismproject.com/history/ |
| 5. | Mountaineer Autism Project. “Board of Directors.” Accessed September 29, 2026. https://mountaineerautismproject.com/board/ |
| 6. | New York State Department of Health. “Reimbursement Change for Unlicensed Individuals Providing Applied Behavior Analysis Services.” New York State Medicaid Update. 2026;42(9). August 2026. https://www.health.ny.gov/health_care/medicaid/program/update/2026/no09_2026-08.htm |
| 7. | Nelson J. “Mountaineer Autism Project takes part in We Develop ABA campaign to increase workforce development in WV.” WAJR. May 20, 2026. https://wajr.com/2026/05/20/mountaineer-autism-project-takes-part-in-we-develop-aba-campaign-to-increase-workforce-development-in-wv/ |
| 8. | West Virginia Birth to Three. Program overview (lead agency for Part C of the Individuals with Disabilities Education Act). Accessed September 29, 2026. https://www.wvdhhr.org/birth23/ |
| 9. | West Virginia Legislature. Session announcement: “The 1st Session of the 88th Legislature will begin January 13th, 2027 at noon.” Legislature homepage. Accessed September 30, 2026. https://home.wvlegislature.gov/ |
| 10. | KFF. “Medicaid Coverage Rates for People Ages 0-64 by Age.” State Health Facts, 2024 (American Community Survey data), West Virginia, children ages 0-18. Accessed September 30, 2026. https://www.kff.org/medicaid/state-indicator/people-0-64-medicaid-rate-by-age/ |
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