Key Takeaways
- Join every waiver list your child qualifies for on the same day: Each waiver keeps its own list, and The Arc of Texas tells families to get on all of them as early as possible.
- The free printable kit on this page has the call sheet and the checklist: It lists who to call for each waiver and what to write down while you wait.
- ABA therapy doesn't have to wait for a waiver slot: Texas Medicaid pays for it through the regular children's benefit, so you can start ABA today while you hold your place in line.
Get on every Texas waiver list this week, with the number and questions for each call.
We also sent the link to your email.
Apply to every Texas Medicaid waiver your child qualifies for, and do it today. The state runs six of them for children, and each program keeps its own list. Your child's name sits on file until funding opens a place, and Texas fills those places first come, first served. The phone number and the directories you need are below.
Which waiver should you apply for?
A Medicaid waiver is federal permission that lets Texas pay for care at home instead of care in an institution. It funds what regular Medicaid won't, like respite care and help with daily living. Each program was built for a different group, so the right one depends on your child's diagnosis and level of need.
An intellectual or developmental disability, shortened to IDD, affects learning, reasoning, or everyday skills. It starts before adulthood. Match your child to the lines below, and join every one that fits.
- A child under 21 with complex medical needs who would otherwise need nursing home care: MDCP.
- A child with a disability other than an intellectual disability that began before age 22: CLASS.
- A child of any age with an intellectual or developmental disability: HCS.
- A child with that same kind of disability who lives at home or on their own: TxHmL.
- A child who is deafblind and has another significant disability: DBMD.
- A child ages 3 to 18 with serious mental, emotional and behavioral difficulties: YES.
Plenty of children fit more than one line, and that's normal. You sign up for each list separately, and The Arc of Texas tells families to join all of them as early as possible. Outside the waiver system, our guide to statewide autism support options is the place to start.
Paying for ABA therapy
Alpaca Health accepts Texas Medicaid, including STAR Kids, and many private plans, and verifies your benefits before therapy starts so you know what your plan covers.
Check your coverage →
What happens after you join a list
Texas keeps a running file of the families who want each waiver. Your child's name goes on it the day you call, and that file is the interest list. It doesn't promise a slot, because the state funds only so many places each year.
When funding opens a place, the agency calls or writes. You get a short window to answer. If the agency can't reach you, your record can be marked inactive, and a letter goes to your last known address. For MDCP, staff try again after the enrollment packet goes out, and a closed release can be reopened. Call the moment you think you missed a notice.
Keep your phone number and mailing address current with every agency you called, and update them the week you move. Call once a year to confirm your child is still on each list. Write down the date, the program, and who you spoke to, so you have your own record of every call.
The six waivers side by side
The table below lines up every program on one screen. It gives the age range and the group each program was built for. It also lists the level of care and the office you call to join.
A funded place is called a slot, and Texas pays for a set number of them each year. A family comes off a list only when one of those places opens, which is how waits run into years. The Texas HHS program comparison page has the official description of each one. The rows below come from the state's side-by-side waiver chart.
| Waiver | Ages | Primary Population | Level of Care | Apply Through |
|---|---|---|---|---|
| MDCP | 0 to 20 | Medically complex children | Nursing facility | 1-877-438-5658 |
| CLASS | All ages (began before 22) | Disability other than intellectual | ICF/IID | 1-877-438-5658 |
| HCS | All ages | Intellectual/developmental disability | ICF/IID | Local LIDDA |
| TxHmL | All ages | IDD, living at home or on their own | ICF/IID | Local LIDDA |
| DBMD | All ages | Deafblindness plus another disability | ICF/IID | 1-877-438-5658 |
| YES | 3 to 18 | Serious mental health needs | Psychiatric inpatient | Local LMHA |
The level of care column uses three terms worth spelling out. An ICF/IID level means your child needs the daily help an intermediate care facility gives, which is a high bar. A nursing facility level means a nursing home would otherwise be the setting. A psychiatric inpatient level points to inpatient mental health care in the same way.
MDCP, CLASS, and DBMD: the three you join by phone
One number covers these three. It's the line for the Texas Health and Human Services Commission, or HHSC, which runs long-term care programs. Call 1-877-438-5658 and ask to be added to each list your child qualifies for. You can do all three in one call, though that line doesn't cover the two programs your local office runs.
MDCP, the Medically Dependent Children Program
MDCP pays for home care for children age 20 and younger whose medical needs would otherwise mean a nursing facility. It covers respite, family support services, employment help, and small home modifications. Only your child's income counts here, not your household's. The waiver comparison chart shows the same rule for every program here except TxHmL. That one does count a parent's income for a child.
CLASS, Community Living Assistance and Support Services
CLASS is for people with a related condition. Texas defines that as a disability other than an intellectual disability that began before age 22. Texas HHS lists the services as respite and support family services, plus employment services and behavioral support. Nursing, specialized therapies, and adaptive aids are part of it too. Qualifying takes that diagnosis, Medicaid coverage, and an ICF/IID level of care.
DBMD, Deaf Blind with Multiple Disabilities
DBMD is for people who are deafblind and have at least one more significant disability. It pays for intervener services, meaning one-on-one support from someone trained to relay what's going on around your child. Orientation and mobility training and employment services come with it. HHSC takes DBMD list requests at that same number.
HCS, TxHmL, and YES: the three you join locally
These three go through a local office instead of the statewide number, so who you call depends on where you live. For HCS and TxHmL, that office is your LIDDA, the local intellectual and developmental disability authority for your area. For YES, it's your LMHA, the local mental health authority. Texas HHS publishes a LIDDA directory covering every county. Its mental health authority search and service area map do the same for the LMHAs.
HCS, Home and Community-based Services
HCS serves people with IDD at any age. That makes it a long-term pathway for adults as well as children. It pays for residential services, respite, and employment services. It also pays for individualized skills and socialization, the service Texas used to call day habilitation. Your LIDDA handles HCS enrollment, so that's the office to call.
TxHmL, Texas Home Living
TxHmL serves people with IDD who live in their family's home or their own home. Texas HHS lists respite, individualized skills and socialization, employment services, nursing, specialized therapies, and adaptive aids among its services. Your LIDDA handles this one as well, so you can ask about both programs in one call.
YES, Youth Empowerment Services
YES is for children ages 3 to 18 with serious mental, emotional and behavioral difficulties. It pays for respite, community living supports, family supports, specialized therapies, and adaptive aids. The aim is to keep a child at home instead of in residential treatment. Ask your local mental health authority to add your child to the YES waiver inquiry list, which is what Texas calls it.
How long the interest lists run
The Arc of Texas waiver guide counts more than 170,000 Texans waiting on these lists. It says the wait runs as much as 16 years for some waivers. The length moves with funding, with your program, and with where you live.
HHSC keeps the master lists, and your LIDDA or LMHA does the screening and the follow-up calls. People come off a list in the order they joined it.
A phone number the agency can't reach is what puts a record inactive, so the yearly check-in matters. In the meantime, your child can use what regular Medicaid already covers.
You don't have to figure this out alone.
Alpaca Health matches your family with an independent BCBA in Texas and handles the insurance paperwork and scheduling so you can focus on your child.
Get matched with a BCBA →
Does a waiver cover ABA therapy?
No, ABA is not a line item in any of the six programs. Your child doesn't need a slot to start it. Texas Medicaid pays for ABA for children age 20 and younger through EPSDT (short for Early and Periodic Screening, Diagnostic and Treatment). That's the part of Medicaid that covers what a child medically needs. Waivers add what the regular plan won't fund, like respite care and adaptive aids at home.
That split is why your child can start ABA and hold a waiver spot at the same time. The Texas Medicaid ABA benefit has its own approval steps, and none of them touch your place on an interest list.
You can find a Texas BCBA who takes Medicaid while the list runs. A BCBA is a board certified behavior analyst, the clinician who assesses your child and writes the therapy plan. For a sense of the first few months, read our guide to early ABA therapy for toddlers.
Get on every Texas waiver list this week, with the number and questions for each call.
We also sent the link to your email.
How to apply, step by step
Everything below takes about an afternoon, and most of it is phone calls. If you can, work through the whole list in one sitting. Asking for every list on one day is the step families skip.
- Call the right office for each waiver. For MDCP, CLASS, and DBMD, call HHSC at 1-877-438-5658. For HCS and TxHmL, call your local LIDDA. For YES, call your local LMHA and ask for the YES waiver inquiry list.
- Ask for every list your child qualifies for. You can do that in the same afternoon, since the lists are kept program by program.
- Check in once a year. Call HHSC and your LIDDA or LMHA to confirm your child is still on each list and that your contact details are current.
- Answer as soon as a program reaches you. If the agency can't reach you, your record can go inactive, and a closed release can sometimes be reopened when you call back.
- Keep your documents in one folder. Your child's Medicaid ID, current diagnosis paperwork, and a summary of the services your child gets now are the ones to have ready.
Texas fills places in the order families joined, so the day you call sets your child's position. Joining several lists in one call is normal, and the intake worker won't ask you to choose.
The kit on this page puts all five steps on one printable page. There's a line for each call and for what you were told. Keep it with your child's Medicaid paperwork so the yearly check-in takes minutes.
What to do while you wait
Regular Texas Medicaid already covers a lot. None of it depends on a waiver slot. ABA therapy, speech therapy, and occupational therapy are all available to children age 20 and younger through the EPSDT benefit. If your child isn't getting them yet, that's the first call to make. Texas HHS also says that getting other services does not change your child's place in line on any interest list.
Community First Choice is the next call. Texas added it in 2015, and it pays for attendant care and habilitation with no interest list of its own. It goes to Medicaid recipients who meet an institutional level of care, which is a narrower group than Medicaid as a whole. Texas HHS says people on a waiver interest list may qualify for it while they wait. Ask your caseworker about your child.
Medicaid Buy-In for Children helps when your household income sits above the regular Medicaid limits. It covers a child 18 or younger who has a disability, and Texas HHS sets the monthly payment on a sliding scale. That payment runs from nothing up to $230, based on your income and on whether your child has employer coverage.
Grants cover some of the rest. The PDSES grant gives eligible families a one-time $1,500 grant for approved educational services. Applications open once a year through the Texas Education Agency, first come, first served. ACT Today awards grants for autism treatment and services, and our roundup of Texas autism grants has more worth an application.
Families paying out of pocket can compare ABA rates by Texas city and check what autism coverage under Texas insurance requires.
Several groups help with the paperwork at no cost. Texas Parent to Parent, Disability Rights Texas, Partners Resource Network, and The Arc of Texas support families through waiver applications and appeals. Protect TX Fragile Kids is a parent-run nonprofit that works on Texas policy for medically complex children.
How Alpaca Health Helps Texas Families
Alpaca Health accepts Texas Medicaid, including STAR Kids, and bills ABA under the children's benefit. Starting care doesn't depend on a waiver slot. You give us your child's Medicaid details at intake, and we match your family with an independent BCBA in Texas.
From there, the BCBA meets your child and runs an assessment. The plan that follows is built around the skills you said matter most at home. Your place on every list stays where it is while that happens. If you're ready to start ABA while the waiver lists run, start your intake today.
Get on every Texas waiver list this week, with the number and questions for each call.
We also sent the link to your email.
Frequently asked questions about Texas Medicaid waivers
Which Texas Medicaid waiver should I apply for first?
Ask for every list your child qualifies for instead of picking one. If your child has an intellectual or developmental disability, HCS and TxHmL both go through your LIDDA on the same call. You can add MDCP or CLASS through the HHSC number the same afternoon.
How long are the Texas Medicaid waiver waitlists?
The Arc of Texas says the wait runs as much as 16 years for some waivers. The length depends on the program, on where you live, and on how much funding the state puts into new places. Join now and check in every year, since your place is set by the day you called.
Does a Texas Medicaid waiver cover ABA therapy?
ABA comes through the regular Texas Medicaid children's benefit for anyone age 20 and younger. A waiver slot has nothing to do with it. Alpaca Health accepts Texas Medicaid and bills ABA that way, and you can get started today while the lists run.
What happens when my child turns 21 on MDCP?
MDCP is for children age 20 and younger. Ask your caseworker what comes next well before your child reaches that age. HCS has no age limit, and joining its list early matters for a child who will need support as an adult.
Support for the hard days.
When you are ready for expert support, Alpaca Health matches your family with a BCBA who can help with the hardest moments, at home, in a clinic, or by telehealth.
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