ABA runs through Carelon, not Maryland Physicians Care
Being enrolled in Maryland Physicians Care doesn't limit which ABA provider you can choose, since authorization is handled entirely by Carelon.
Maryland Physicians Care ABA therapy coverage
Your Maryland Physicians Care coverage, explained
Insurance jargon should never stand between your child and excellent ABA therapy. That's why we handle your coverage, your authorization, and every step in between, so all you have to focus on is your child.
Does Maryland Physicians Care cover ABA therapy?
Yes, though not directly through Maryland Physicians Care itself
Maryland Physicians Care is one of nine Maryland Medicaid HealthChoice managed care organizations, a locally based plan. ABA therapy is completely carved out of Maryland Physicians Care and every other HealthChoice MCO. Your ABA authorization and billing run through Carelon Behavioral Health, regardless of which MCO you're enrolled in.
What makes your coverage work
The specifics that matter
Authorization lasts up to 180 days
Reassessment and fresh authorization are required roughly every 6 months for as long as treatment continues.
No dollar cap, EPSDT-driven
Coverage is a federal entitlement for eligible children under 21 with a documented autism diagnosis.
Worth knowing: Carelon has had real system-wide delays
Maryland officials reported a significant claims backlog and call center issues to the state legislature in January 2026. The state says most of that eased by the end of 2025, but we stay closely on top of your authorization status given this history.
How the process works
From your first call to your first session
- 01
Step 1: Schedule a free consultation
Call (888) 690-0663. We listen and learn what your family needs before anything else happens.
- 02
Step 2: We verify your benefits
We confirm your Maryland Physicians Care enrollment and your child's Medicaid eligibility.
- 03
Step 3: We submit your prior authorization to Carelon
This includes a comprehensive diagnostic evaluation, a BCBA-led treatment plan, and required documentation.
- 04
Step 4: Therapy begins
Your child starts sessions at home, at school, or wherever makes the most sense.
- 05
Step 5: We manage your reauthorization
Every 180 days, through Carelon.
Why families choose Apex ABA for their Maryland Physicians Care coverage
What your coverage is actually paying for
Maryland Medicaid covers ABA therapy because it works, but it's worth knowing exactly what that coverage buys your child.
Communication
Finding words and the confidence to use them. Asking for help. Expressing needs.
Independence
Doing more, needing less help, one skill at a time.
Social Connection
Playing alongside others, then with them.
Self-Regulation
Fewer meltdowns. More tools to handle the hard moments.
Daily Routines
Mornings, mealtimes, transitions, smoother than you thought possible.
Family Life
Less crisis management. More time to just be family.
How your coverage plays out at Apex
Coverage is one thing. What happens with it is another.
Given the reported delays with Carelon, having a provider who tracks your authorization closely matters more than usual right now.
At Apex, you're in the room
Not sidelined while decisions get made about your child. Not waiting to hear about it after the fact.
Small caseloads mean your authorization actually gets used well
We limit our caseloads on purpose. That means your BCBA knows your child and pushes for answers if the process slows down.
Your benefits cover therapy where your child actually lives
In-home therapy during real family moments. School-based therapy during class, recess, lunch.
You see exactly how your coverage is being spent
Weekly check-ins with your BCBA. Live coaching during real moments. Written strategies you can use between sessions.
“From the moment we got in touch with Apex about our 2-year-old daughter, we felt a weight was lifted off our shoulders. They're really there for you. Kind, compassionate, and experts in the field.”
— Haiden C., Maryland
ABA therapy services covered
What your coverage can include
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In-Home ABA Therapy — real family moments: breakfast, getting ready, bedtime
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School-Based ABA Therapy — support during class, recess, and lunch
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Parent Training and Support — tools for the hours we're not there
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Daycare ABA Therapy — support at your child's daycare or early learning center
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Weekend ABA Therapy — because progress doesn't take Saturdays off
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Early Intervention ABA Therapy — for toddlers and preschoolers, when it matters most
Maryland Physicians Care coverage across Maryland
Where we serve Maryland Physicians Care families
Our Maryland office is based at 400 East Pratt Street, 8th Floor, in Baltimore, and we provide in-home ABA therapy statewide.
Maryland Physicians Care ABA therapy FAQs
What you're probably wondering
No. ABA is carved out of all Maryland Medicaid MCOs, including Maryland Physicians Care. Carelon Behavioral Health manages it, regardless of your MCO.
A comprehensive diagnostic evaluation, a BCBA-led treatment plan, and required assessment documentation.
Up to 180 days, with reassessment required to continue.
We help you appeal with additional documentation from your child's evaluation and our clinical team.
More coverage options in Maryland
Don't have Maryland Physicians Care?
We also work with CareFirst BlueCross BlueShield, Jai Medical Systems, Kaiser Permanente, Priority Partners, MedStar Family Choice, Aetna Better Health, CareFirst Community Health Plan, United Healthcare, and Wellpoint Maryland.
CareFirst BlueCross BlueShield 
Jai Medical Systems 
Kaiser Permanente 
Priority Partners 
MedStar Family Choice 
Aetna Better Health 
CareFirst Community Health Plan 
United Healthcare 
Wellpoint Maryland 
Let's find out exactly what your Maryland Physicians Care plan covers.
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