Wyoming ABA Therapy Rates 2026: Provider Shortage and Rate Restoration
What Happened to Wyoming's ABA Rates
During the COVID-19 pandemic, Wyoming used enhanced federal matching funds under the American Rescue Plan Act (ARPA) to increase Medicaid reimbursement rates for home and community-based service providers, including Applied Behavior Analysis (ABA) therapists. Those enhanced rates brought the behavioral technician code 97153 to $19.23 per unit — a rate that sustained a functional provider network across the state.
When the ARPA funding expired on September 1, 2025, the state published an expiration rate table that dropped the 97153 code from $19.23 to $7.00 per unit. The impact was immediate. Private ABA providers across Wyoming suspended developmental services, closed regional clinics, and laid off direct-care staff. Rural counties — already struggling with provider scarcity in a state where the nearest behavioral analyst might be a three-hour drive — were hit hardest.
The 2026 Rate Restoration
The Wyoming Legislature recognized the crisis and responded. During the 2026 session, legislators appropriated approximately $10 million in combined state and federal funds to restore waiver provider reimbursement rates. The July 22, 2026, fee schedule brought the 97153 technician code back to $19.23 per unit — matching the ARPA-era rate that had kept providers in business.
The restoration solved the immediate funding problem, but it could not undo ten months of damage to the provider network. Clinics that closed during the rate collapse did not all reopen. Staff who left the field moved to other states or other industries. Families who lost their providers during the gap were placed back on waiting lists for agencies that now operated at reduced capacity.
What This Means for Families Now
The rate restoration means Wyoming Medicaid again pays a viable rate for ABA services. But the practical question for families — especially those in rural communities — is whether a provider is available to deliver those services at all.
Families in this situation have two options:
Wait for an agency provider. If a Board Certified Behavior Analyst (BCBA) or a registered behavioral technician (RBT) is accepting new clients in the family's area, this is the traditional path. The provider bills Medicaid directly under the waiver, and the family coordinates scheduling with the case manager.
Move to self-directed care. If no agency provider is available — a common reality in non-urban Wyoming counties — families can elect the self-directed service delivery model under Chapter 46, Section 12. In this arrangement, the parent or legal representative becomes the Employer of Record, contracts with the state's Financial Management Service (ACES$), and directly recruits, hires, and trains employees to deliver services. The family manages payroll documentation, maintains EVV (Electronic Visit Verification) compliance, and tracks spending against the individual waiver budget.
Self-directed care requires significantly more administrative work than agency-based services, but for families in areas where the provider network collapsed during the ARPA expiration, it may be the only way to access funded services that are already authorized in the individual plan of care.
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The Electronic Visit Verification Requirement
Starting July 1, 2026, Wyoming requires providers whose waiver services are subject to EVV — including self-directed employees when applicable — to meet a minimum 70% monthly EVV compliance rate. EVV systems document the time, location, and type of service delivered. Providers who fall below 70% compliance face enforcement action.
For families managing self-directed care for EVV-required services, every shift their hired staff works must be clocked through the approved EVV system. The case manager can provide access to the system and training on documentation requirements.
Planning Around Provider Availability
Families entering the waiver system now should not assume that a funded waiver slot guarantees access to ABA or other specialized services. The gap between authorization and actual service delivery is real in Wyoming. The Wyoming SSI at 18 & Adult Disability Benefits Guide includes a self-directed budget tracker and employer-of-record checklist for families who need to manage care delivery directly — along with the step-by-step process for transitioning from agency-based to self-directed services within an existing individual plan of care.
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