Alpaca Health FAQs: Texas Insurance, PDSES Funding, and ABA Costs in Dallas
Alpaca Health FAQs: Texas Insurance, PDSES Funding, and ABA Costs in Dallas
Does CHIP cover ABA therapy in Texas?
No, the Children’s Health Insurance Program (CHIP) in Texas does not currently cover Applied Behavior Analysis (ABA) therapy. The Texas Health and Human Services CHIP benefits page describes CHIP coverage as standard medical care (doctor visits, prescriptions, preventive care), but ABA therapy is not listed as a covered benefit. Families who need ABA typically explore Medicaid, private insurance, or state programs instead.
CHIP vs. Medicaid: Understanding ABA coverage
Texas Medicaid
- Texas Medicaid does cover comprehensive ABA therapy for children with an autism diagnosis when services are medically necessary. Coverage is authorized based on medical necessity rather than a fixed annual hour limit. Learn more in Alpaca’s guide: Does TX Medicaid cover ABA therapy in Texas?
CHIP
- CHIP is designed for families who earn too much for Medicaid but cannot afford private insurance. While it covers many medical services, CHIP does not include ABA therapy.
Some families may qualify for Medicaid instead of CHIP depending on income and disability eligibility. You can also start by contacting local support and eligibility resources such as 2-1-1 Texas.
Additional resources:
- Medicaid Applied Behavior Analysis (ABA) Services - Community First HealthPlans (Texas Medicaid informational page)
Alternative options for ABA therapy
If your child is enrolled in CHIP, these options may help cover autism-related supports.
Children’s Autism Program (CAP)
The Texas Health and Human Services Children’s Autism Program (CAP) can provide up to 180 hours of ABA annually for eligible children ages 3-15. Fees are typically based on a sliding scale. CAP is not the same as comprehensive ABA coverage, but it can offer meaningful support.
Private insurance
Some employer-sponsored plans cover ABA due to the Texas autism insurance mandate. The legal basis is typically tied to Texas Insurance Code §1355.015.
Grants and other funding
You can explore additional funding pathways in Alpaca’s guide: Grants for Autism in Texas autism grants.
Getting ABA therapy through Alpaca Health
Alpaca Health accepts many Texas insurance plans. You can review supported plans here: Alpaca Health insurance.
Families can often receive care in settings that fit real life, including:
To get started, families can use the Alpaca Health intake process.
How long does the PDSES Grant take to be funded?
The Parent-Directed Special Education Services (PDSES) grant application process in Texas can take several months, often up to six months, for review and funding. Applications are processed in the order they are received, and due to high demand and limited annual funds, some approved applications may be placed on a waitlist until additional funding becomes available. For the most current information, start with the Texas Education Agency PDSES program page and the official TEA PDSES FAQs.
PDSES grant timeline breakdown
While timing can vary, the PDSES process typically includes:
- Application submission: Families apply through a My SPEDTex account. TEA’s parent resources are here: SPEDTex parents
- Processing time: Review can take months, and often up to six months depending on volume
- Waitlist status: If annual PDSES funds are exhausted, approved applications may be placed on a waitlist until new funds are available
- Award notification: Approved families receive access to a $1,500 award through the program’s purchasing process
- Tracking status: Families can monitor progress through their My SPEDTex account
What to do while waiting for PDSES funding
While your application is processing:
- Check the TEA PDSES page for updates
- Monitor your application in My SPEDTex
- Gather documentation and confirm which expenses may qualify under PDSES rules
Some families begin services while their PDSES application is pending, then pursue reimbursement later if the expenses meet PDSES eligibility and documentation requirements.
Accessing ABA therapy without waiting
Families do not need to delay exploring ABA therapy while waiting for PDSES.
ABA may be available through:
- Private insurance
- Texas Medicaid
- Private pay arrangements
Alpaca can help families connect with providers quickly, with flexible options such as:
To explore next steps, start here: Alpaca Health intake.
How much does ABA therapy cost in Dallas, Texas?
ABA therapy in Dallas typically costs $120 to $150 per hour for professional services, though rates vary by provider credentials and care setting. Without insurance, intensive 30–40 hour weekly programs can total $62,400 to $249,600 per year. With insurance or Medicaid, out-of-pocket costs are often much lower, and many Texas health plans cover ABA under state requirements such as Texas Insurance Code §1355.015.
Additional resources:
- Medicaid Applied Behavior Analysis (ABA) Services - Texas (Informational)
ABA therapy cost breakdown in Dallas
ABA is usually billed hourly, so costs scale quickly with weekly hours.
Common ranges include:
Hourly rates
- Behavior Technicians (BTs): $50–$75 per hour
- Board Certified Behavior Analysts (BCBAs): $100–$160 per hour
Estimated weekly costs without insurance
- 10 hours per week: $1,200–$1,500
- 20 hours per week: $2,400–$3,000
- 30 hours per week: $3,600–$4,500
- 40 hours per week: $4,800–$6,000
Estimated monthly costs
- Roughly $5,000–$20,000 for comprehensive programs
How insurance and Medicaid affect ABA therapy costs
Texas coverage is shaped by state requirements and the type of plan you have. The Texas autism insurance mandate is typically referenced through Texas Insurance Code §1355.015.
Many families pay substantially less than the full hourly rate once coverage applies, often paying:
- Copays
- Coinsurance
- Deductibles until met
After a family hits an annual out-of-pocket maximum, insurance may cover most remaining eligible costs for the year.
For plan guidance, see Alpaca Health insurance and Medicaid-specific information in Alpaca’s resource: Does TX Medicaid cover ABA therapy in Texas?.
Alternative funding options for ABA therapy
Families may also explore:
- The Texas HHS Children’s Autism Program (CAP)
- Local resource roundups such as Alpaca’s Guide to autism resources in Dallas, Texas
- Provider lists like Top autism providers in Dallas, Texas, a family guide
- Payment plans or reduced rates offered by some clinics for private pay families
Getting started with ABA therapy in Dallas
Alpaca connects Dallas families with qualified ABA providers who accept insurance and offers flexible care settings, including:
To begin, visit the Alpaca Health intake.
High Quality, Local ABA
If you are ready to partner with a local BCBA and receive the highest quality of care, reach out today!
