Wyoming’s pediatric ABA rate holds mid-range while its DD waiver cut 97153 to $7.00 after ARPA funds lapsed. A July 2026 schedule restored the waiver rate to $19.23.
Key Takeaways
- A funding cliff cut waiver ABA pay. When enhanced pandemic-era federal funding for home- and community-based services expired, Wyoming’s developmental disability waivers dropped the technician code 97153 from $19.23 to $7.00 per unit, effective September 1, 2025. The reduction hit a specific date rather than following a policy judgment about the value of care.
- The 2026 Legislature funded a full restoration. Lawmakers earmarked roughly $10 million to raise waiver provider rates, and the July 2026 fee schedule restored the waiver ABA codes to their pre-pandemic levels, including 97153 back to $19.23 per unit.
- The pediatric rate runs on a separate track. Wyoming’s July 2026 state-plan schedule sets 97153 at $12.30 and 97155 at $24.60 per 15-minute unit, distinct from the waiver line and confirmed against the state’s own fee schedule.
- Two pipelines, two stories. Wyoming pays for children’s ABA through EPSDT and for adults’ behavioral support through the DD waivers. A cut in one lane does not describe the other.
Wyoming’s Medicaid reimbursement for autism therapy tells two stories at once, and only one of them is a cut. On the pediatric side, the state’s fee-for-service rate for the workhorse technician code 97153 sits at $12.30 per 15-minute unit on the state’s July 2026 schedule, near the bottom of its neighbor set. On the developmental disability waiver side, the rate the state pays for the same service fell off a cliff in 2025, dropping from $19.23 to $7.00 per unit when enhanced pandemic-era federal funding expired, then climbing back to $19.23 when the July 2026 schedule took effect. Untangling those two pipelines is the key to understanding where Wyoming’s ABA reimbursement actually stands, and where the 2026 Legislature pushed it.
How Wyoming Medicaid Pays for ABA: Two Separate Pipelines
Wyoming reaches children with autism and adults with developmental disabilities through different doors. For Medicaid-enrolled children under 21, ABA runs through the Early and Periodic Screening, Diagnostic, and Treatment benefit on the state’s fee-for-service schedule. Wyoming’s July 2026 state-plan schedule sets the 97153 rate at $12.30 per 15-minute unit and the analyst code 97155 at $24.60. For adults, the Comprehensive and Supports Waivers, the state’s two developmental disability waivers, fund ABA under a service line the state calls Behavioral Support Services, available to individuals 21 and older with an autism diagnosis and prior Division approval.
That split matters because a rate change in one lane says nothing about the other. The waiver ABA rates and the pediatric EPSDT rates are set through different mechanisms and move on different clocks. A reader who hears that Wyoming cut its 97153 rate is hearing about the waiver, not the children’s benefit, and conflating the two would misstate what families and pediatric providers actually face.
Medicaid 97153 (adaptive behavior treatment by protocol, technician-delivered), maximum allowable rate per 15-minute unit: Wyoming and selected neighboring states, as of July 2026. Source: MediRate.
On the technician code, MediRate’s comparison places Wyoming at $12.30, above only Montana’s $11.36 in the neighbor set and below Colorado ($17.20), Nebraska ($18.70), and Utah ($19.67). For granular state-by-state detail across the full ABA code set, MediRate maintains the underlying datasets.
The ARPA Cliff: Why Wyoming’s Waiver ABA Rates Dropped
The sharp move came on the waiver side, and it was a funding cliff rather than a policy judgment about the value of autism care. During the pandemic, the American Rescue Plan Act gave states enhanced federal money for home- and community-based services, and Wyoming used part of it to lift waiver provider rates. When that enhanced funding expired, the state published an ARPA Expiration Rate Table tied to a waiver amendment effective September 1, 2025, resetting rates to their post-enhancement levels. For the three ABA codes the waivers cover, the drop was steep: Behavioral Support Services delivered by a technician (97153) fell from $19.23 to $7.00 per unit, the assistant-analyst code (97152) from $20.56 to $9.36, and the analyst code (97151) from $32.27 to $24.55.
The mechanism is worth stating plainly because it changes the story. Wyoming did not decide that a unit of waiver ABA was suddenly worth a fraction of its prior value. A temporary federal subsidy ended, and the rates returned to a level the state’s base funding could sustain. That distinction is small comfort to a provider watching a $19.23 unit become a $7.00 unit, but it explains why the reduction hit on a specific date and why the fix took the form of new appropriations rather than a rate-methodology fight.
Medicaid 97155 (adaptive behavior treatment with protocol modification, analyst-delivered), maximum allowable rate per 15-minute unit: Wyoming and selected neighboring states, as of July 2026. Source: MediRate.
On the analyst code, MediRate places Wyoming at $24.60, in the middle of its neighbor set, ahead of Montana ($20.46) and Nebraska ($22.72) but well behind Utah’s $37.51. Utah’s figure reflects a new permanent rate mechanism that some states are using to defend analyst pay against future cuts.
Medicaid 97155 (adaptive behavior treatment with protocol modification, analyst-delivered), maximum allowable rate per 15-minute unit: Wyoming and selected neighboring states, as of July 2026. Source: MediRate.
On the analyst code, MediRate places Wyoming at $24.60, in the middle of its neighbor set, ahead of Montana ($20.46) and Nebraska ($22.72) but well behind Utah’s $37.51. Utah’s figure reflects a new permanent rate mechanism that some states are using to defend analyst pay against future cuts.
The 2026 Restoration and Where Wyoming Sits Regionally
Wyoming’s 2026 budget session set the recovery in motion. Against a backdrop of proposed health spending cuts and a legislative push to return to what some lawmakers called pre-pandemic spending levels, the Legislature ultimately added money for the developmental disability waivers rather than trimming them. Roughly $10 million in combined state and federal funds was earmarked to raise waiver provider rates, and about $9 million more to reduce the waiver waitlist, according to reporting on the session and the Department of Health’s own notices describing the funding as a partial restoration of rates that had been reduced. That money has now landed: the state’s July 2026 fee schedule restored the waiver ABA codes to their pre-pandemic levels, returning 97153 to $19.23, the assistant-analyst code (97152) to $20.56, and the analyst code (97151) to $32.27, reversing the September 2025 cuts in full.
Wyoming’s neighbors show how varied the regional picture has become. Utah moved to lock in an analyst rate through a permanent statutory mechanism. Colorado, by contrast, is absorbing the fallout of a federal audit that flagged tens of millions in improper ABA payments. Nebraska, which the state itself described as paying the highest ABA rates in the nation before an August 1, 2025 adjustment, cut its rates to align more closely with surrounding states. Wyoming sits inside that churn as a state whose waiver rate whipsawed on the federal funding cycle, cut in 2025 and restored in 2026. The broader wave, from Indiana’s phased reductions to New York’s cut to 97153, has already fed sector strain visible in behavioral health layoffs.
For providers, the open questions have narrowed: the restored waiver rates took effect in July 2026 and returned the codes to their pre-expiration levels in full, so what remains is whether the higher pay is enough to rebuild capacity after nearly a year at $7.00 per unit. As states cut and restore ABA rates one at a time, some operators are pressing for a coordinated national approach to reimbursement and oversight. For now, Wyoming’s answer is a state-specific one: a funding cliff on the waiver, a legislative fix that reversed it, and a separate pediatric schedule.
Frequently Asked Questions
Does Wyoming Medicaid cover ABA therapy?
Yes. Wyoming covers ABA for Medicaid-enrolled children under 21 through the Early and Periodic Screening, Diagnostic, and Treatment benefit, and separately funds Behavioral Support Services for adults 21 and older through its Comprehensive and Supports Waivers.
Did Wyoming cut its Medicaid ABA rates?
The developmental disability waivers cut their ABA rates when enhanced pandemic-era federal funding expired, dropping 97153 from $19.23 to $7.00 per unit effective September 1, 2025. The July 2026 fee schedule then restored those waiver rates to their pre-pandemic levels. The pediatric state-plan rate is set separately.
What are Wyoming’s Medicaid ABA rates?
On the state’s July 2026 fee-for-service schedule, Wyoming’s 97153 is $12.30 and 97155 is $24.60 per 15-minute unit. On the developmental disability waivers, the same codes pay more after the July 2026 restoration, with 97153 back to $19.23.
Is Wyoming raising ABA rates in 2026?
Yes. The 2026 Legislature appropriated roughly $10 million to raise developmental disability waiver provider rates, and the July 2026 fee schedule implemented the increase, restoring the waiver ABA codes to their pre-pandemic levels. About $9 million more went toward reducing the waiver waitlist.
