Federal auditors checked four states for autism therapy billing. In all four, nearly every claim they sampled had something wrong. The national data shows the same pattern in every state they have not checked yet.
Medicaid ABA spending grew from $448 million to $2.03 billion nationally between 2019 and 2023. Four state audits found the same documentation failures independently. National data shows why: one billing code has held 72 to 77 percent of spending every year, and the growth came from new entrants, not consolidation.
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