State guide

New York

Programs, dollars, and people that serve autism families in New York. Federal protections always apply on top of what you see here.

New York overview

New York's Office for People With Developmental Disabilities (OPWDD) is the state agency for developmental disabilities services across the lifespan. Contact your regional DDSO (Developmental Disabilities Service Office) to begin eligibility. OPWDD's Front Door process is the entry point. New York City has the highest concentration of autism resources in the country; families upstate often have more limited access. INCLUDEnyc is NYC's PTI; Resources for Children with Special Needs serves families elsewhere. The New York Center for Autism, Center for Autism and the Developing Brain, and NYU Langone's autism programs are major resources.

Verify program names, URLs, and eligibility on official .gov sites — these change.

⏰ Act now — Medicaid waiver waitlist

OPWDD Home and Community Based Services Waivers

Typical wait: 5–10 years

Apply through OPWDD at diagnosis — waiver services have long waitlists and earlier application means earlier access.

Apply or learn more →

Statewide resources

These four programs exist in every state and are the fastest entry points for most families.

Medicaid / HCBS Waiver

New York OPWDD HCBS Waivers

State waiver program for home and community-based services. Apply the day of diagnosis.

Insurance Coverage

Whether private insurance must cover ABA therapy in New York.

New York requires insurance to cover ABA therapy

Insurance Law §3216(i) · effective 2011

No age capNo dollar capDiagnosis required

One of the strongest mandates in the country — no age cap and no dollar cap. Requires autism diagnosis and a licensed BCBA. Self-funded employer plans (ERISA) are still exempt; confirm your plan type with HR.

Self-funded employer plans (ERISA) are typically exempt — ask your HR department which type of plan you have.

Medicaid Waiver

Home and community-based services (HCBS) for autism families in New York.

OPWDD Comprehensive Support Services

New York Office for People With Developmental Disabilities (OPWDD)

Varies

Typical wait time

2-4 years for some services; varies widely by service type and region

Coverage highlights

  • ✓Respite
  • ✓Supported Living
  • ✗Therapy
  • ✓Employment Supports

New York OPWDD provides a broad range of supports through its network of voluntary provider agencies and Medicaid. Services are coordinated through Care Coordination Organizations (CCOs). Families should apply for OPWDD eligibility determination early, even if full waiver services aren't immediately needed, to establish the record.

How to apply

Apply online →518-473-1997

Medicaid Managed Care

How Medicaid pays for ABA therapy in New York.

New York Medicaid Managed Care

Covers ABA through under 21

How to find your plan

Visit health.ny.gov/health_care/medicaid or call NY Medicaid CHOICE at 1-800-505-5678. Your plan name is on your Medicaid card.

Major plans in this state

  • Healthfirst
  • Fidelis Care (Centene)
  • UnitedHealthcare Community Plan of New York
  • Molina Healthcare of New York

New York Medicaid uses regional managed care plans. ABA therapy is covered for children under 21 through EPSDT. HCBS waiver services for autism are managed separately through OPWDD (Office for People with Developmental Disabilities) — these are different from medical MCO services. Prior authorization is required for ABA through your MCO.

⚠️ Prior authorization is required before starting ABA services.