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CMS unveils ABA toolkit and heat map amid sharp rise in ABA spending
Summary
CMS announced an ABA toolkit and a national Medicaid service‑area heat map showing concentrated growth in applied behavioral analysis (ABA) spending; officials said national ABA spending rose from $2 billion to $10 billion between 2021 and 2025 and flagged states with unusually rapid growth.
CMS officials said the agency is releasing an ABA toolkit and a Medicaid service‑area heat map intended to help states spot anomalous spikes in ABA spending and to set standards for clinical justification and individualized treatment plans.
"This toolkit's gonna do 3 things," Dan Brohman, director for Medicaid and CHIP services, said: require individualized treatment plans that reflect clinical need; encourage integrated therapy rather than maximizing ABA hours in isolation; and put guardrails in place to prevent crowding out children who need services. Brohman cited federal data showing ABA spending nationally rose from about $2 billion to $10 billion a year between 2021 and 2025 — a 420% increase — and said Pennsylvania ranks near the top in several metrics.
Brohman said the toolkit aims to help states set individualized treatment plans, integrate therapies, and create guardrails so resources are available for children with the greatest clinical need. He also cited parent‑reported delays and wait lists and said the toolkit will be shared with states to drive accountability.
