# Some kids with autism are losing therapy services after a Medicaid change reduces clinics’ revenue

- URL: https://theranews.net/blog/2026-04-08-some-kids-with-autism-are-losing-therapy-services-after-a-medicaid-change-reduce-ee2ae5/
- Published: 2026-04-08
- Type: Archive summary (AI-assisted summary of third-party reporting)
- Original outlet: vnews
- Original report: https://vnews.com/2026/04/07/vermont-medicaid-aba-billing-changes/
- Topics: mental-health-policy
- Publisher: TheraNews, operated by AdvancedCare USA Inc.
- Notice: Educational content, not medical, legal, billing or financial advice. Cite the original outlet, not this summary.

> Keene Perspectives and other ABA providers in Vermont are struggling to adapt to a change in how Vermont Medicaid pays for its services, which has caused a drastic drop in revenue and threatens their ability to continue providing services.

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Several ABA clinics in Vermont are discharging Medicaid patients following billing changes made by Vermont Medicaid in January. Until the end of 2025, Medicaid paid ABA providers for both behavioral technician and board certified behavior analyst (BCBA) concurrent services. Beginning in January, Medicaid no longer allows providers to bill for both the BCBA and behavior technician's concurrent services, which Medicaid says was "not correct coding."

Vermont Medicaid says it made the change to address federal scrutiny under the Trump administration regarding state spending in Medicaid. Last summer, the federal government found Wisconsin had paid $18.5 million for "improper" ABA billing claims. Medicaid's billing structure uses lump sums, with providers submitting the number of hours a client receives services rather than specific services provided. Previously, if a child spent 10 hours per week with a behavior technician and 2 hours with a BCBA, the clinic could bill for 12 hours. Now, only the 10 hours can be billed.

The revenue loss has forced several clinics to discharge Medicaid patients. Keene Perspectives reported a 16% revenue drop in January and February and has begun discharging half of its Medicaid patients, including a 6-year-old with profound autism who was making significant progress in communication and social engagement. Little Royals Early Intervention Center reported a 17% income drop and drops in payment for individual clients ranging from 15% to 50%. Some clinics are considering closing entirely.

A Medicaid policy analyst for the Vermont Agency of Human Services acknowledged that rates may need to change to reflect the amount of work required per hour of care. The Department of Vermont Health Access stressed that it is monitoring how providers respond and wants to ensure changes are not creating undue strain on patients and families. The department emphasized its primary concern is ensuring members have access to clinically appropriate care.

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*This article is an AI-assisted summary. All facts and figures are drawn from the original report: [https://vnews.com/2026/04/07/vermont-medicaid-aba-billing-changes/](https://vnews.com/2026/04/07/vermont-medicaid-aba-billing-changes/)*