Yes. Virginia Medicaid covers ABA therapy for children under 21 with a formal autism spectrum disorder diagnosis through the federal EPSDT benefit.
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Virginia's Medicaid managed care program is called Medallion 4.0. Most Medicaid enrollees receive coverage through one of Virginia's contracted MCOs — Anthem HealthKeepers Plus, Aetna Better Health of Virginia, Molina Healthcare of Virginia, Optima Health Community Care, or United Healthcare Community Plan. The MCO you're enrolled in determines your ABA provider network.
Virginia Medicaid is the state's Medicaid program. Virginia uses a managed care model called Medallion 4.0, with most enrollees covered through a contracted MCO. For autism services, the MCO administers the EPSDT benefit and manages prior authorization for ABA therapy.
Coverage runs through the federal EPSDT benefit. In practice, you will need:
In practice, expect to need:
As of January 1, 2026, a federal rule (CMS-0057-F) requires Medicaid managed care plans to decide standard prior authorization requests within 7 calendar days, and urgent requests within 72 hours.
Use Harmony Care Finder's Virginia provider directory to find ABA providers near you. Confirm in-network status specifically with your Virginia Medicaid MCO — Medallion 4.0 networks vary between plans.
Check your coverage to confirm your plan details, and use our Virginia provider directory to find ABA providers near you.
Medallion 4.0 is Virginia's Medicaid managed care program. Most Medicaid enrollees are covered through one of five contracted MCOs under this program.
Virginia contracts with Anthem HealthKeepers Plus, Aetna Better Health of Virginia, Molina Healthcare of Virginia, Optima Health Community Care, and United Healthcare Community Plan.
No. Anthem HealthKeepers Plus is a Virginia Medicaid MCO. Commercial Anthem plans are a separate product with different coverage terms and provider networks.
Let us check your benefits and match you with providers who accept your plan. It's free.
Check My Coverage →This content is for informational purposes only and does not constitute medical, clinical, or therapeutic advice.
Data current as of July 2026.