Georgia Medicaid Waivers for Autism Services: What Families Need to Know
In short: Georgia offers two main HCBS waivers-COMP (comprehensive) and NOW (limited)-that can help cover autism services like ABA therapy. However, many children receive ABA through standard Georgia Medicaid under the EPSDT benefit, which doesn't require a waiver. Waitlists for waivers can be long, so apply early and explore all funding options.
Key takeaways
- Georgia Medicaid's EPSDT benefit covers medically necessary ABA therapy for children under 21 without a waiver.
- The COMP waiver provides comprehensive long-term supports; the NOW waiver offers a limited set of services.
- Applying for a waiver doesn't guarantee approval-waitlists often stretch years.
- Eligibility for waivers requires a qualifying disability, financial need, and an institutional level of care.
Understanding Georgia Medicaid Waivers for Autism Services
If you're raising a child with autism in Georgia, you've likely heard about Medicaid waivers. These waivers-officially called Home and Community-Based Services (HCBS) waivers-are designed to help people with disabilities receive care at home rather than in an institution. For families of autistic children, the most relevant are the COMP (Comprehensive Supports) Waiver and the NOW (New Options Waiver). Both are administered by the Georgia Department of Community Health (DCH) and operated with the Department of Behavioral Health and Developmental Disabilities (DBHDD).
It's important to know that waivers are not the only path to ABA therapy in Georgia. Thanks to the federal Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit, standard Georgia Medicaid covers medically necessary applied behavior analysis (ABA) for children under age 21. That means your child may not need a waiver at all to start ABA. However, waivers can help cover additional services like respite care, personal support, and community integration-things that go beyond ABA alone.
🔗 Related reading: New York Medicaid Waivers for Autism Services: A Guide · Find ABA Near Me
What Are the Two Main HCBS Waivers?
The COMP Waiver (Comprehensive Supports Waiver)
The COMP waiver is the more expansive option. It provides a full range of services, including:
- Residential support
- Day services and community integration
- Respite care
- Nursing and therapy services
- Behavioral intervention (which includes ABA)
This waiver is ideal for individuals with significant needs who require round-the-clock support. However, it also has the longest waitlist-often stretching 7 to 10 years or more. For young children, it's wise to apply as early as possible but not rely on it for immediate ABA coverage.
The NOW Waiver (New Options Waiver)
The NOW waiver offers a more limited set of services, typically focused on:
- Respite care
- Community access
- Prevocational services
- Behavioral intervention (again, can include ABA)
The NOW waiver generally has a shorter waitlist than COMP, but still runs several years. It's intended for individuals who can live at home with moderate support. Both waivers require that the individual qualifies for an institutional level of care (such as an intermediate care facility for people with intellectual disabilities).
How Do These Waivers Cover ABA Therapy?
Both the COMP and NOW waivers list behavioral intervention as a covered service. This can include ABA therapy, provided by a qualified behavioral specialist-often a Board Certified Behavior Analyst (BCBA) or a supervisor working under one. However, the waiver's coverage of ABA may be limited in hours or scope compared to what's available through EPSDT.
Here's the key detail: If your child is under 21 and has standard Georgia Medicaid, ABA therapy is already covered as a medically necessary treatment under EPSDT. That means you can get up to 30+ hours per week of ABA if prescribed by a doctor, without needing a waiver slot. The waiver, in contrast, might be used to fund additional wrap-around services (like respite) that EPSDT does not cover.
Some families use both: EPSDT for intensive ABA, and a waiver for respite, transportation, or behavioral support in other settings. But keep in mind that waiver behavioral intervention might overlap with EPSDT ABA, so it's important to coordinate with your providers and case manager.
🔗 Related reading: Aetna ABA Therapy Ohio Pre-Authorization Guide · Local ABA Therapy
Who Qualifies? Eligibility Criteria for Georgia Waivers
To be eligible for either COMP or NOW, an individual must:
- Be a Georgia resident and U.S. citizen or qualified non-citizen
- Meet financial eligibility for Medicaid (income and asset limits)
- Have a diagnosis of intellectual disability, developmental disability, or related condition (autism qualifies as a developmental disability)
- Require an institutional level of care (i.e., the need for services typically provided in a nursing facility or ICF/ID)
- Be on the DBHDD waitlist for waiver services
Children with autism who do not also have an intellectual disability may still qualify if they demonstrate a severe functional impairment. The evaluation is done through a comprehensive assessment by DBHDD.
Note: There is also the Katie Beckett Waiver (officially the Georgia Pediatric Program, or GAPP), which provides Medicaid coverage for children under 18 with significant disabilities whose family income exceeds standard Medicaid limits. While it doesn't directly cover ABA, it opens the door to EPSDT coverage, including ABA.
How to Apply for a Georgia Medicaid Waiver
Applying for a COMP or NOW waiver involves several steps:
- Contact your local DBHDD regional field office. You can find your region on the DBHDD website. They will help start the eligibility process.
- Complete a pre-admission screening. This determines whether the individual meets the level of care criteria.
- Submit a waiver application. Once approved for level of care, you are placed on the statewide waitlist. The wait time varies dramatically.
- Work with a case manager if you are selected from the waitlist. They will help develop a person-centered plan.
Be prepared: The waitlists are long. As of early 2025, the COMP waiver has over 10,000 people waiting, and the NOW waiver has several thousand. New slots are added each year, but demand far exceeds supply.
While you wait, apply for standard Georgia Medicaid if your income qualifies. All children in Georgia with family income up to 148% FPL are eligible for PeachCare or Medicaid. Many autistic children also qualify through SSI or TEFRA (the Katie Beckett pathway).
Waitlist Realities and Alternative Funding
Let's be honest: waiting for a waiver slot should not be your only plan. ABA therapy is time-sensitive-early intervention is most effective. Your child should start ABA as soon as a diagnosis is received. Fortunately, Georgia Medicaid through EPSDT covers ABA without a waiver. You simply need:
- A diagnosis of autism spectrum disorder
- A prescription from a licensed physician for ABA therapy
- To find a provider who accepts Georgia Medicaid
Additionally, some families use private insurance if available. Georgia has mandated ABA coverage for most commercial plans under the state's autism insurance reform law (often called "Helen's Law"). Our free matching service can help you find providers that accept your specific plan-whether commercial, Medicaid, or both.
Using Insurance and Our Free Matching Service
Navigating insurance and waivers is tough. That's where ABA Clinics Near Me comes in. We are a completely free, no-obligation referral service. We connect families with vetted, BCBA-led ABA providers in Georgia who accept your insurance-including Georgia Medicaid, PeachCare, and most private plans. You tell us your child's needs and location, and we match you with clinics that have openings.
Here's how it works:
- Fill out a short form on our website.
- We review your insurance coverage and preferences.
- We provide a list of providers who meet your criteria.
- You choose the best fit and they handle the rest.
We don't charge families or providers for the match-it's our mission to get every child the therapy they deserve quickly.
Practical Tips for Families
To wrap up, here are actionable steps you can take today:
- Apply for Georgia Medicaid right away. Even if you think you earn too much, check for TEFRA/Katie Beckett options.
- Get a prescription for ABA from your child's developmental pediatrician or neurologist. Then use our service to find a provider.
- Start the waiver application now, even if you expect to use EPSDT. The waitlist will eventually open up, and you'll want to be on it.
- Keep records. Save all assessments, doctor's notes, and insurance letters. You'll need them for both Medicaid and waiver reviews.
- Stay connected with the Georgia Parent Mentor Partnership or local autism support groups. They can offer real-world advice on navigating the system.
Remember: You are not alone in this journey. Thousands of Georgia families have used Medicaid waivers and EPSDT to get life-changing ABA therapy for their children. And with a free matching service like ours, you can find a BCBA-led provider in your area who accepts your coverage-no waiting, no stress.