Indiana Increases Proposed Reimbursement Rates for Autism Therapy Services


The Indiana Family and Social Services Administration (FSSA) has revised its proposed reimbursement rates for autism therapy services catering to children covered by Medicaid. This adjustment comes in the wake of widespread apprehension among providers and state legislators over the initially proposed lower rate.

The FSSA has settled on a rate of $68 per hour, factoring in a heightened allowance for administrative overhead expenses and additional funds to account for non-billable time spent by supervisors. The state aims to implement this rate adjustment in January.

While there is consensus on the need for a standardized rate for Applied Behavior Therapy reimbursement, providers expressed concern that the state's initial proposal — $55 for the most prevalent form of therapy — would necessitate such substantial adaptations that providers might be compelled to downsize staff, curtail services, or even cease operations.

Following the initial proposal, the FSSA received an influx of feedback, with hundreds of comments pouring in. More than 40 state lawmakers also rallied behind the cause, signing a letter urging Gov. Eric Holcomb to intervene.

Indiana ACT for Families, an alliance representing parents, therapists, and providers, remains dissatisfied with the revised rate. They characterize the decision as "callous" and remain apprehensive that it may lead to a reduction in services for children with autism.

In an official statement, the coalition implored, "We ask that Governor Holcomb direct FSSA to reconsider the cuts and have a fulsome discussion with the thousands of Hoosier families who will feel this detrimental impact to come to a reasonable, transparent rate agreement that is fair for all stakeholders."

The FSSA underscores that the revised $68 rate surpasses those of neighboring states such as Ohio, Illinois, and Kentucky. Furthermore, it aligns with the national average of $68 observed in states that disclose this data.