Massachusetts has expanded insurance coverage to ensure that most health plans in the Commonwealth will cover Applied Behavior Analysis (ABA) for children with Down syndrome, effective January 1, 2026. Previously, ABA was generally covered for Down syndrome only when paired with an autism diagnosis. The new law requires coverage for Down syndrome alone for services delivered on or after the effective date.
The statute requires coverage of the treatment of Down syndrome through speech therapy, occupational therapy, physical therapy, and applied behavior analysis services, and does not limit the site of service, meaning eligible care can be delivered in-center when medically necessary and consistent with plan rules.
“Coverage that includes ABA, Speech, and OT lets families and clinicians choose what’s best for each child’s goals. We’re partnering with payers, pediatricians, and schools to implement this thoughtfully, so children with Down syndrome can benefit from high-quality, in-center care when it supports their development and helps them thrive,” says Tahra Cessna, M.S., BCBA, Executive Vice President of Organizational Growth and Development at Bierman Autism Centers.
Coverage applies across MassHealth, Massachusetts-regulated commercial plans (including HMOs), and state employee plans administered by the Group Insurance Commission. Standard plan processes (benefits verification, medical necessity, prior authorization, and in-network participation) will continue to apply.
As coverage expands, Bierman Autism Centers is integrating services for children with Down syndrome into PEBBL, our outcomes and research program. PEBBL is preparing to launch a focused line of research to validate the benefits of ABA for children with Down syndrome, strengthen our outcomes infrastructure, and help shape best-practice standards, keeping therapy joyful, ethical, and evidence-driven for families statewide.
Bierman Autism Centers provides in-center ABA, Speech, and Occupational Therapy through a playful, child-led model that meets each child where they are. Families can begin benefits checks and clinical consults now to prepare for January start dates. Our Intake team handles authorizations and onboarding. Coverage applies to dates of service on or after January 1, 2026.
Bierman serves families from centers in Bedford, Needham, and Quincy, with a Danvers location opening this Spring.
We’ll verify your 2026 benefits, guide prior authorization, and schedule a family-centered consult.
Bierman Autism Centers is a trusted leader in autism care, dedicated to helping children with autism grow, play, and thrive. Since 2006, Bierman has been transforming lives through play-based, individualized ABA therapy, empowering children to build essential skills like self-advocacy, communication, and independence.
Bierman’s approach combines evidence-based practices with the joy of play, creating an engaging environment where children are excited to learn and grow. With a dual focus on delivering exceptional outcomes for children and developing great clinicians and teachers, Bierman raises the bar on clinical excellence. Inspired by the teaching hospital model, Bierman emphasizes mentorship, training, and collaboration to ensure every child—and every team member—reaches their full potential.
Bierman offers comprehensive services, including ABA therapy, Speech and Occupational Therapies, and Diagnostic Evaluations, all tailored to meet each child’s unique needs. By fostering a culture of continuous learning and individualized care, Bierman helps children make meaningful progress while providing families with compassionate support throughout their journey.
With over 375 successful graduations and centers in Arizona, Indiana, Massachusetts, North Carolina, New Jersey, Ohio, and Rhode Island, Bierman Autism Centers continues to set the standard in autism care. To learn more about Bierman’s approach and how it is creating progress and possibilities® for children, families, and clinicians, visit www.biermanautism.com.
