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Autism Services

Autism Spectrum Disorder (ASD) is a developmental disability that can cause significant social, communication, and behavioral challenges. A diagnosis of ASD now includes several conditions that used to be diagnosed separately: autistic disorder, pervasive developmental disorder not otherwise specified, and Asperger syndrome. The Centers for Disease Control and Prevention maintains data and statistics on ASD including prevalence data and other ASD-related studies.

Autism Spectrum Disorder and Medicaid

In response to the increased interest and activity related to ASD, CMS has provided a series of information and guidance intended to increase awareness and understanding of ASD and the role that Medicaid can play in supporting beneficiaries with this diagnosis across the lifespan.

On July 7, 2014, CMS released an Informational Bulletin to provide information on the options available under the federal Medicaid program for furnishing services to eligible individuals with ASD. The Informational Bulletin outlines the Medicaid coverage categories that are available to cover ASD treatment and intervention services. The Bulletin also discusses requirements for individuals eligible for Early and Periodic Screening, Diagnostic and Treatment (EPSDT) and the relationship between EPSDT and services to treat ASD under a section 1915(c) waiver or section 1915(i) Medicaid state plan program.  

In addition, on September 24, 2014, CMS released a set of Frequently Asked Questions (FAQs) to respond to questions raised by states and stakeholders regarding autism services.

On July 12, 2024, CMS released the 2024 Medicaid & Children’s Health Insurance Program (CHIP) Beneficiaries at a Glance: Autism infographic. The infographic provides an overview of the prevalence of autism, characteristics of Medicaid and CHIP beneficiaries with autism, prevalence of common co-occurring health conditions, and utilization of treatment services.

Questions related to autism services may be directed to the autism services mailbox at AutismServicesQuestions@cms.hhs.gov.

Reports and Research

In 2010, CMS released an environmental scan of the scientific evidence regarding the efficacy, effectiveness, safety, and availability of ASD-related psychosocial services and supports for children, youth, and adults with ASD. This report, entitled Autism Spectrum Disorders Services: Final Report on Environmental Scan describes findings from the literature review, including data on the evidence base for interventions for individuals with autism across the age span as well as data on the significant costs associated with caring for individuals with autism.

In January, 2014, CMS released a report entitled, Autism Spectrum Disorders (ASD) State of the States of Services and Supports for People with ASD which provides a nationwide summary of state services for people with Autism Spectrum Disorder (ASD) and policies related to people with ASD. The report provides information on existing programs and policies in all 50 states and the District of Columbia. The report stemmed from the Interagency Autism Coordinating Committee’s (IACC’s) 2010 and 2011 Strategic Plans. (Note: Due to the size of this report, smaller files of state profiles organized by geographical region and the background information are also available upon request from the Contracting Officer’s Representative listed on the report cover.)

In September 2024, CMS released comprehensive guidance to support states in meeting EPSDT requirements and to highlight strategies and best practices for states in implementing those requirements. This guidance was required by section 11004 of Title I of Division A of Bipartisan Safer Communities Act (BSCA) (P.L. 117–159).

Interagency Autism Coordinating Committee (IACC)

CMS is a statutory member of the Interagency Autism Coordinating Committee (IACC), a federal advisory committee that coordinates Federal efforts and provides advice to the Secretary of Health and Human Services on issues related to autism spectrum disorder (ASD). For more information on the IACC, visit their webpage.

The 2022 HHS Report to Congress on Supportive Services for Individuals with Autism is a helpful resource describing federal autism services and support activities.

For additional Autism-related reports, visit the Publications page on the IACC website.