<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<meta name="description" content="From Nov 1, 2026, KanCare needs autism diagnoses for ages 20 and under from a qualified psychologist or physician. Who counts, the 2-year grace, what to do.">
<title>KanCare Autism Diagnosis Rule: Who Can Diagnose Your Child From November 1, 2026 | Kansas Medicaid ABA Therapy, Eligible Providers, the 2-Year Grace Period | Achieving Stars Therapy</title>
<link rel="preconnect" href="https://fonts.googleapis.com">
<link rel="preconnect" href="https://fonts.gstatic.com" crossorigin>
<link href="https://fonts.googleapis.com/css2?family=DM+Sans:wght@400;500;600&family=Fraunces:opsz,wght@9..144,500;9..144,600&display=swap" rel="stylesheet">
<style>.gx{--white:#FFFFFF;--off-white:#F9FAFB;--gold:#F5A623;--gold-light:#FEF7E8;--navy:#1A2B4A;--navy-soft:#2D3E5F;--gray:#4B5563;--border:#E5E7EB}.gx *{margin:0;padding:0;box-sizing:border-box}.gx{font-family:'DM Sans',system-ui,sans-serif;background:var(--off-white);color:var(--navy);line-height:1.7;font-size:17px}.gx h1{font-family:'Fraunces',Georgia,serif;font-size:clamp(28px,6vw,42px);font-weight:600;line-height:1.15;color:var(--white);margin-bottom:16px}.gx h2{font-family:'Fraunces',serif;font-size:24px;font-weight:600;color:var(--navy);margin-bottom:16px;padding-bottom:8px;border-bottom:2px solid var(--gold)}.gx h3{font-family:'Fraunces',serif;font-size:19px;font-weight:600;color:var(--navy);margin:24px 0 10px}.gx p{margin-bottom:14px;color:var(--navy-soft)}.gx a{color:var(--navy);font-weight:600;text-decoration:underline;text-underline-offset:2px}.gx a:hover{color:var(--navy-soft)}.gx ul,.gx ol{margin:14px 0;padding-left:24px}.gx li{margin-bottom:8px;color:var(--navy-soft)}.gx strong{color:var(--navy)}.gx table{width:100%;border-collapse:collapse;margin:18px 0;font-size:15px}.gx th,.gx td{padding:10px 12px;text-align:left;border-bottom:1px solid var(--border);vertical-align:top}.gx th{background:var(--gold-light);color:var(--navy);font-weight:600;font-family:'Fraunces',serif}.gx .hero{background:linear-gradient(135deg,var(--navy) 0%,var(--navy-soft) 100%);padding:130px 24px 48px;text-align:center}.gx .hero-inner{max-width:720px;margin:0 auto}.gx .location-badge{display:inline-block;background:var(--gold);color:var(--navy);font-size:12px;font-weight:600;letter-spacing:0.06em;text-transform:uppercase;padding:6px 14px;border-radius:20px;margin-bottom:16px}.gx .hero p{font-size:18px;color:rgba(255,255,255,0.92);line-height:1.7;max-width:600px;margin:0 auto}.gx .quick-info{display:grid;grid-template-columns:repeat(3,1fr);gap:16px;background:var(--white);border-radius:12px;padding:24px;margin:-32px auto 32px;max-width:800px;box-shadow:0 4px 20px rgba(26,43,74,0.08);position:relative;z-index:10}.gx .info-item{text-align:center}.gx .info-label{font-size:12px;color:var(--gray);text-transform:uppercase;letter-spacing:0.05em;margin-bottom:4px}.gx .info-value{font-size:15px;font-weight:600;color:var(--navy)}.gx .content{max-width:800px;margin:0 auto;padding:24px 24px 72px}.gx section{margin-bottom:36px}.gx .highlight-box{background:var(--gold-light);border-left:4px solid var(--gold);border-radius:0 10px 10px 0;padding:18px 22px;margin:20px 0}.gx .highlight-box p{margin:0;color:var(--navy)}.gx blockquote{border-left:4px solid var(--navy);background:var(--white);padding:14px 18px;margin:14px 0;border-radius:0 10px 10px 0;color:var(--navy)}.gx .table-wrap{overflow-x:auto}.gx .src{font-size:14px}.gx .src li{margin-bottom:4px}.gx .src a{display:inline-block;vertical-align:top;padding:0 0 21px}.gx .disclaimer{font-size:13px;color:var(--gray);font-style:italic;margin-top:20px;padding:12px;background:var(--off-white);border-radius:8px}.gx .cta-section{background:linear-gradient(135deg,var(--navy) 0%,var(--navy-soft) 100%);border-radius:16px;padding:40px 32px;text-align:center;margin-top:36px}.gx .cta-section h2{color:var(--white);border:none;padding:0;margin-bottom:12px;font-size:26px}.gx .cta-section p{color:rgba(255,255,255,0.92);margin-bottom:8px;font-size:17px}.gx .cta-button{display:inline-block;background:var(--gold);color:var(--navy);font-weight:600;font-size:16px;padding:14px 32px;border-radius:8px;text-decoration:none;margin-top:20px}.gx .cta-grid{display:grid;grid-template-columns:repeat(auto-fit,minmax(200px,1fr));gap:16px;margin-top:20px}.gx .cta-item{background:rgba(255,255,255,0.1);border-radius:10px;padding:18px;min-width:0}.gx .cta-item-label{font-size:12px;color:#FFE1A3;text-transform:uppercase;letter-spacing:0.05em;margin-bottom:6px}.gx .cta-item-value{color:var(--white);font-weight:600;font-size:15px;overflow-wrap:anywhere;min-width:0}.gx .cta-item-value a{color:var(--white);text-decoration:none;display:inline-block;padding:12px 0;overflow-wrap:anywhere}@media (max-width:600px){.gx .quick-info{margin:-24px 16px 24px;grid-template-columns:repeat(2,1fr)}.gx .cta-grid{grid-template-columns:1fr}.gx table{font-size:14px}.gx th,.gx td{padding:8px}.gx .w45{width:62%}}.gx .hero,.gx .ash-hero,.gx .ash-loc-page .ash-hero{padding-top:130px !important}.gx .hero.hp{position:relative;overflow:hidden;background:var(--navy);padding-bottom:84px}.gx .hp-reel{position:absolute;inset:0}.gx .hp-reel img{position:absolute;inset:0;width:100%;height:100%;object-fit:cover;object-position:center 30%;opacity:0;animation:7.2s linear infinite}.gx .hp-reel .s1{opacity:1;animation-name:hpa}.gx .hp-reel .s2{animation-name:hpb}.gx .hp-reel .s3{animation-name:hpc}.gx .hero.hp::after{content:"";position:absolute;inset:0;background:linear-gradient(180deg,rgba(26,43,74,.6),rgba(26,43,74,.76))}.gx .hero.hp .hero-inner{position:relative;z-index:2}@keyframes hpa{0%{opacity:1;transform:scale(1)}31%{opacity:1;transform:scale(1.08)}35%,96%{opacity:0;transform:scale(1.08)}100%{opacity:1;transform:scale(1)}}@keyframes hpb{0%,31%{opacity:0;transform:translateY(5%) scale(1.12)}35%{opacity:1;transform:translateY(0) scale(1.12)}64%{opacity:1;transform:translateY(0) scale(1.02)}68%,100%{opacity:0}}@keyframes hpc{0%,64%{opacity:0;transform:translateX(-4%) scale(1.14)}68%{opacity:1;transform:translateX(-4%) scale(1.14)}96%{opacity:1;transform:translateX(3%) scale(1.14)}100%{opacity:0}}.gx .hp-chk{position:absolute;opacity:0;width:1px;height:1px}.gx .hp-pause{position:absolute;right:12px;bottom:40px;z-index:3;min-height:44px;min-width:64px;padding:12px 14px;border-radius:22px;background:rgba(26,43,74,.7);color:#fff;font-size:13px;font-weight:600;cursor:pointer;text-align:center}.gx .hp-pause::after{content:"Pause"}.gx .hp-chk:checked~.hp-pause::after{content:"Play"}.gx .hp-chk:checked~.hp-reel img{animation-play-state:paused}.gx .hp-chk:focus-visible~.hp-pause{outline:2px solid var(--gold)}@media (prefers-reduced-motion:reduce){.gx .hp-reel img{animation:none}.gx .hp-reel .s2,.gx .hp-reel .s3,.gx .hp-pause{display:none}}.gx .pb,.gx .ig{margin:30px 0;border-radius:14px;overflow:hidden;background:var(--white);border:1px solid var(--border)}.gx .pb img{display:block;width:100%;height:auto;aspect-ratio:2/1;object-fit:cover;object-position:center 30%}.gx .ig img{display:block;width:100%;height:auto}.gx .pb figcaption,.gx .ig figcaption{font-size:13px;color:var(--gray);padding:8px 14px}.gx .toc{background:var(--white);border:1px solid var(--border);border-radius:12px;padding:16px 20px;margin:0 0 28px}.gx .toc b{display:block;font-size:13px;text-transform:uppercase;letter-spacing:.05em;color:var(--gray);margin-bottom:6px}.gx .toc ol{margin:0;padding-left:20px;columns:2;column-gap:28px}.gx .toc li{margin-bottom:4px;font-size:15px}.gx .steps{list-style:none;padding:0;counter-reset:s}.gx .steps li{counter-increment:s;position:relative;padding:12px 14px 12px 54px;background:var(--white);border:1px solid var(--border);border-radius:10px;margin-bottom:10px}.gx .steps li::before{content:counter(s);position:absolute;left:12px;top:12px;width:30px;height:30px;border-radius:50%;background:var(--navy);color:#fff;font-weight:600;text-align:center;line-height:30px}.gx details.acc{background:var(--white);border:1px solid var(--border);border-radius:10px;margin-bottom:10px}.gx details.acc summary{cursor:pointer;padding:14px 16px;font-family:'Fraunces',serif;font-weight:600;font-size:17px;color:var(--navy);min-height:44px}.gx details.acc>div{padding:0 16px 6px}.gx .note{font-size:14px;color:var(--gray)}@media (max-width:600px){.gx .stack table,.gx .stack tbody,.gx .stack tr,.gx .stack td{display:block;width:100%}.gx .stack tr:first-child{display:none}.gx .stack tr{border:1px solid var(--border);border-radius:10px;margin:0 0 10px;padding:8px 12px;background:var(--white)}.gx .stack td{border:none;padding:4px 0}.gx .stack td:first-child{font-weight:600;color:var(--navy)}.gx .stack td::before{display:block;font-size:12px;color:var(--gray);text-transform:uppercase;letter-spacing:.04em}}@media (max-width:600px){.gx .toc ol{columns:1}.gx .pb img{aspect-ratio:4/3}.gx .hp-pause{bottom:36px}}</style>
</head>
<body>
<div class=gx><div class="hero hp"><input type=checkbox id=hpp class=hp-chk aria-label="Pause the hero photos"><label for=hpp class=hp-pause
></label><div class=hp-reel aria-hidden=true><img class=s1 src="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3ce26e04561e501f424f1_kancare-h1-1400.webp" srcset="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3ce285433cf85dc9d3396_kancare-h1-700.webp 700w,https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3ce26e04561e501f424f1_kancare-h1-1400.webp 1400w" sizes=100vw alt="" fetchpriority=high><img class=s2 src="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3ce2be04561e501f4273f_kancare-h2-1400.webp" srcset="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3ce2df76eadd687b7a755_kancare-h2-700.webp 700w,https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3ce2be04561e501f4273f_kancare-h2-1400.webp 1400w" sizes=100vw alt="" loading=lazy><img class=s3 src="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3ce4453671da49a860c8b_kancare-h3-1400.webp" srcset="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3ce46e003a12dc0a2758b_kancare-h3-700.webp 700w,https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3ce4453671da49a860c8b_kancare-h3-1400.webp 1400w" sizes=100vw alt="" loading=lazy></div><div class=hero-inner><span class=location-badge>Kansas Medicaid Guide</span><h1>KanCare's New Autism Diagnosis Rule: Who Can Diagnose Your Child From November 1</h1><p>From November 1, 2026, only a doctoral psychologist or a qualified physician can sign it for KanCare members 20 and under.</p></div></div>
<div class=quick-info><div class=info-item><div class=info-label>Starts</div><div class=info-value>November 1, 2026</div></div><div class=info-item><div class=info-label>Who It Covers</div><div class=info-value>KanCare, ages 20 and under</div></div><div class=info-item><div class=info-label>Who Can Diagnose</div><div class=info-value>Doctoral psychologist or listed physician</div></div><div class=info-item><div class=info-label>Already in ABA</div><div class=info-value>2 years to update</div></div><div class=info-item><div class=info-label>Test Named</div><div class=info-value>Such as ADOS or CARS</div></div><div class=info-item><div class=info-label>Appeal Window</div><div class=info-value>60 calendar days</div></div></div>
<div class=content>
<section><p>KanCare is the Kansas Medicaid program. Its new rule changes who is allowed to sign an autism diagnosis, not who can get ABA therapy. If the right kind of clinician signs, nothing else about your child's care has to change.</p>
<div class=highlight-box><p><strong>The short version.</strong> From November 1, 2026, a diagnosis for anyone 20 or younger on KanCare must come from a doctoral-level psychologist licensed by the Kansas BSRB, or from a developmental pediatrician, psychiatrist, neurologist, or primary care doctor with documented autism training. Kids already approved and in ABA get two years. A report from a master's-level clinician is not on the list, so ask your plan before you rely on one.</p></div>
<p>A parent on r/kansas put the worry plainly in August 2026:</p>
<blockquote>"Kancare MCOs (Medicaid) including Healthy Blue, sunflower and United will no longer pay for autism spectrum diagnosis unless a person is seen by a PhD Psychologist or an MD" <span class=note>(<a href="https://www.reddit.com/r/kansas/comments/1voqhie/kancare_mcos_medicaid_including_healthy_blue/" rel="nofollow noopener" target=_blank>Reddit r/kansas</a>)</span></blockquote>
<p>That is close, but the real list is more specific. This page quotes the state's notice itself, then turns it into a checklist you can use before booking an autism evaluation.</p></section>
<nav class=toc><b>On this page</b><ol><li><a href=#rule>What the rule says</a></li><li><a href=#who>Who counts</a></li><li><a href=#report>What the report needs</a></li><li><a href=#already>Already in ABA</a></li><li><a href=#waiting>Still waiting for a diagnosis</a></li><li><a href=#dates>Key dates</a></li><li><a href=#denied>If ABA is denied</a></li><li><a href=#faq>FAQ</a></li></ol></nav>
<section id=rule><h2>What does the new KanCare autism rule say?</h2>
<p>The rule comes from KMAP General Bulletin 26140, the notice Kansas Medicaid sends to providers. Sunflower Health Plan, a KanCare plan, posted the full updated text dated 08/31/26. The key sentence:</p>
<blockquote>"Effective for dates of service on or after November 1, 2026, individuals aged 20 years and younger with autism spectrum disorder (ASD) must receive a diagnosis from a Kansas Behavioral Sciences Regulatory Board (BSRB) clinical psychologist or qualified physician. A multidisciplinary diagnostic approach is preferred."</blockquote>
<p>The first version said September. The update crosses out "September" and puts "November" in its place. UnitedHealthcare's provider page lists both versions, the original on 08.26.2026 and the updated one on 09.02.2026.</p>
<p>One more line matters for timing. The notice warns that "the implementation of State policy by the KanCare Managed Care Organizations (MCOs) may vary from the date noted." So call your child's health plan and ask when it starts checking. The state also folded the change into its Mental Health and Professional Fee-for-Service Provider Manuals, the rule books providers bill under.</p></section>
<section id=who><h2>Who counts as a qualified diagnostician?</h2>
<p>Two groups qualify. For psychologists, the rule says they must have "a doctor's degree in psychology or equivalent training" and "two (2) years of supervised experience delivering BSRB-approved psychological services." For physicians, it gives this list:</p>
<blockquote>"Qualified physicians include: developmental/behavioral pediatricians; psychiatrists; neurologists; primary care physicians with documentation of additional training in the diagnosis of ASD"</blockquote>
<p>Here is how common Kansas licences line up against that wording, from the Kansas Behavioral Sciences Regulatory Board's licence types. The licence letters after a name tell you a lot.</p>
<div class=table-wrap><table>
<tr><th>Who signs the report</th><th>On the list?</th><th>What to do</th></tr>
<tr><td>Licensed psychologist (LP), doctoral degree</td><td>Yes, with two years of supervised experience</td><td>Confirm the licence is from the Kansas BSRB</td></tr>
<tr><td>Developmental or behavioral pediatrician</td><td>Yes</td><td>Book it</td></tr>
<tr><td>Psychiatrist or neurologist</td><td>Yes</td><td>Book it</td></tr>
<tr><td>Primary care doctor or regular pediatrician</td><td>Only with documented extra autism training</td><td>Ask the office for that documentation</td></tr>
<tr><td>Licensed clinical psychotherapist (LCP), master's level</td><td>Not named</td><td>Ask your KanCare plan before you rely on it</td></tr>
<tr><td>Nurse practitioner, licensed specialist clinical social worker (LSCSW), school team</td><td>Not named</td><td>Ask your plan; a school eligibility is not on the list</td></tr>
</table></div>
<p>The LCP row trips people up because the title has "clinical" in it. Kansas law keeps the two licences apart. K.S.A. 74-5362 says a licensed clinical psychotherapist "may not use the title licensed psychologist or psychologist." The notice does not say whether an LCP diagnosis counts. Until a plan says yes in writing, treat it as a risk.</p></section>
<figure class=pb><img src="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3ce5ee04561e501f43fb3_kancare-b1-1400.webp" srcset="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3ce62ab5e67ab9b1a34a1_kancare-b1-700.webp 700w,https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3ce5ee04561e501f43fb3_kancare-b1-1400.webp 1400w" sizes="(max-width:800px) 100vw,800px" alt="A clinician talks with a mother and daughter, papers on the table" loading=lazy width=1400 height=700><figcaption>Stock photo. Ask who will sign the report, and what licence they hold, before the evaluation day.</figcaption></figure>
<section id=report><h2>What does the evaluation report need to include?</h2>
<p>A qualified signature is half of it. The report also has to show the work. The rule lists two requirements for the diagnosis and treatment paperwork:</p>
<ol class=steps>
<li><strong>DSM criteria and severity.</strong> The report gives the diagnostic criteria and symptom severity level from the current Diagnostic and Statistical Manual of Mental Disorders (DSM), the manual clinicians use for a diagnosis of autism.</li>
<li><strong>A validated diagnostic tool.</strong> The rule's words are "such as the Autism Diagnostic Observation Schedule (ADOS) or the Childhood Autism Rating Scale (CARS)." Those are examples, not the only tools allowed.</li>
</ol>
<p>It also recommends, but does not require, a cognitive test and an adaptive behavior measure. A cognitive test the school district already did with a validated tool "may also be included." Bring any school testing you have.</p></section>
<figure class=ig><picture><source media="(max-width:640px)" srcset="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad497ac944eb9e842c55f37_ig-kancare-check-m.png"><img src="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad497aa1bd0c4897c0a1b98_ig-kancare-check-d.png" alt="Flowchart: does an autism diagnosis count for KanCare from November 1, 2026? Step 1: on KanCare and 20 or younger. Step 2: who signed it: doctoral psychologist, developmental or behavioral pediatrician, psychiatrist, neurologist, or primary care doctor with documented autism training counts; master's-level clinicians, nurse practitioners and school teams are not on the list. Step 3: already approved and in ABA means two years to get a qualified provider to confirm it." loading=lazy></picture><figcaption>Achieving Stars Therapy graphic built from KMAP Bulletin 26140 as posted by Sunflower Health Plan, read October 17, 2026.</figcaption></figure>
<section id=already><h2>My child is already in ABA. Do we lose services?</h2>
<p>No, not right away. The rule gives current members a transition window, but only if they are already approved and receiving treatment:</p>
<blockquote>"For individuals already approved and receiving autism treatment, including applied behavioral analysis (ABA) therapy, who have been diagnosed with autism spectrum disorder by a diagnostician who does not meet the updated diagnostician and/or diagnostic requirements as per this policy, will have two (2) years to obtain an updated autism spectrum disorder diagnosis by a qualified diagnostician."</blockquote>
<p>Better news in the next line. The update "does not necessarily need to involve a complete diagnostic evaluation as long as the diagnostic criteria in this policy are met and a qualified diagnostician is confirming the diagnosis." So the first step is to find out who signed your child's original report. If it was a doctoral psychologist or a listed physician, you may already be fine.</p>
<p>And once a qualified clinician diagnoses a child, the notice says no re-evaluation is needed to keep getting therapy, and there is "no time limit on how soon they begin" ABA.</p></section>
<section id=waiting><h2>My child is still waiting for a diagnosis. What should I do now?</h2>
<p>Children who are not yet approved and in treatment do not get the two-year window. From November 1, a new autism spectrum disorder diagnosis has to meet the rule from day one. Five questions to ask before you book:</p>
<ol class=steps>
<li><strong>Who will sign the report?</strong> Get the name and licence. LP means doctoral psychologist. LCP or LMLP means master's level.</li>
<li><strong>Will the report state DSM criteria and a severity level?</strong></li>
<li><strong>Which autism tool will you use?</strong> ADOS and CARS are the two the state names.</li>
<li><strong>Do you take KanCare, and is the evaluator enrolled?</strong> A clinic in Missouri or another state is a question to put to your plan first.</li>
<li><strong>How long is the wait?</strong> Hospital autism programs can take several weeks to several months, so get on a list early.</li>
</ol>
<p>Then call the member services number on your child's health plan card. Ask the plan to confirm, in writing if possible, that a report from that clinician will be accepted.</p></section>
<section id=dates><h2>Key dates at a glance</h2>
<div class=table-wrap><table>
<tr><th>Date</th><th>What happened</th><th>Source</th></tr>
<tr><td>08.26.2026</td><td>Original bulletin listed by UnitedHealthcare</td><td>UnitedHealthcare provider page</td></tr>
<tr><td>08/31/26</td><td>Updated bulletin dated, start moved to November 1</td><td>Sunflower Health Plan copy</td></tr>
<tr><td>09.02.2026</td><td>Updated version listed by UnitedHealthcare</td><td>UnitedHealthcare provider page</td></tr>
<tr><td>November 1, 2026</td><td>Rule applies to dates of service from this day</td><td>Notice 26140</td></tr>
<tr><td>Two years after that</td><td>Window for children already in treatment to get a qualified diagnosis</td><td>Notice 26140</td></tr>
</table></div>
<p class=note>The state's own copy sits on the Kansas Medical Assistance Program (KMAP) provider portal, which would not open for this check. The wording above comes from Sunflower Health Plan's full-text copy.</p></section>
<figure class=pb><img src="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3ce65d9050dcc396844f7_kancare-b2-1400.webp" srcset="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3ce76fe46a3ece426927a_kancare-b2-700.webp 700w,https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3ce65d9050dcc396844f7_kancare-b2-1400.webp 1400w" sizes="(max-width:800px) 100vw,800px" alt="Two parents read paperwork together at a kitchen table" loading=lazy width=1400 height=700><figcaption>Stock photo. Keep the evaluation report, the plan's letters and every date in one folder.</figcaption></figure>
<section id=denied><h2>What if KanCare denies ABA because of the diagnosis?</h2>
<p>You can appeal. Federal Medicaid rules give you a fixed window: an enrollee "has 60 calendar days from the date on the adverse benefit determination notice in which to file a request for an appeal to the managed care plan" (42 CFR 438.402).</p>
<p>The diagnosis is only the first gate. The plan still decides whether ABA is medically necessary and how many hours to approve, so a denial can come from either step. Count from the date printed on the denial letter, not the day it arrived. Write the date on your calendar the day the letter comes. Ask the clinician who did the evaluation for a letter that names their licence and the autism tool they used. Those are the two things the state asks for.</p></section>
<section><h2>Where does Achieving Stars Therapy fit?</h2>
<p>Achieving Stars Therapy does not diagnose autism. It provides the therapy that comes after. Its BCBAs run <a href="https://www.achievingstarstherapy.com/location/states/aba-therapy-kansas">in-home ABA therapy across Kansas</a> for children 18 months to 15 years, and KanCare is accepted.</p>
<p>Before the first session, the team checks your coverage for free. Families in <a href="https://www.achievingstarstherapy.com/location/city/aba-therapy-wichita-ks">Wichita</a> and <a href="https://www.achievingstarstherapy.com/location/city/aba-therapy-kansas-city-ks">Kansas City, Kansas</a> start the same way: one call. Sessions happen at home, between 8am and 8pm, with parent training built in.</p></section>
<section id=faq><h2>Frequently Asked Questions</h2>
<details class=acc><summary>Does my child need a brand-new autism evaluation?</summary><div><p>Not always. If your child is already approved and in ABA, a qualified clinician can confirm the diagnosis within two years, and the bulletin says that update does not always need a complete new evaluation. If the original report was signed by a doctoral psychologist or a listed physician, it may already meet the rule.</p></div></details>
<details class=acc><summary>Is this the same as the Kansas Autism Waiver?</summary><div><p>No. The Autism Waiver is a separate home and community based services program run by the Kansas Department for Aging and Disability Services (KDADS) for children up to age 5. It pays for things like respite and parent training. It does not pay for ABA therapy, and it has had long waitlists. The new rule is only about who can sign the diagnosis.</p></div></details>
<details class=acc><summary>My child is under 3. Do we have to wait for a diagnosis?</summary><div><p>Not for early intervention. Kansas Infant-Toddler Services, which most people call tiny-k, serves children from birth to age 3. It is free at any income, anyone can make the referral, and no diagnosis is required. An autistic child can start there while the autism evaluation is scheduled.</p></div></details>
<details class=acc><summary>Does the rule apply to private insurance?</summary><div><p>No. Notice 26140 is a KanCare rule. Private plans set their own diagnosis requirements, so check your plan's policy.</p></div></details>
<details class=acc><summary>Who is covered by the rule?</summary><div><p>KanCare members aged 20 and younger with autism. Medicaid's children's benefit covers screening and diagnosis for children under 21, and this notice sets the autism diagnosis requirements within it. Adults 21 and over are not named.</p></div></details>
<details class=acc><summary>Is the ADOS required?</summary><div><p>A validated autism tool is required. The state gives the ADOS and the CARS as examples, using the words "such as," so other validated tools may be used.</p></div></details>
<details class=acc><summary>Can a doctor in Missouri diagnose a Kansas child on KanCare?</summary><div><p>The notice does not say. A Missouri clinician would need to fit one of the listed types and work with KanCare. Ask your plan before booking.</p></div></details>
<details class=acc><summary>Does a school evaluation count?</summary><div><p>A school team decides special education eligibility. School teams are not on the state's list of qualified clinicians. A school's cognitive testing can still be included in the medical report.</p></div></details>
<details class=acc><summary>How fast can ABA start after a qualifying diagnosis?</summary><div><p>Medicaid takes longer than private insurance because the plan must approve the treatment plan first. Achieving Stars Therapy checks benefits before the first session at no cost.</p></div></details>
</section>
<section><h2>Sources</h2><ol class=src>
<li><a href="https://www.sunflowerhealthplan.com/newsroom/kmap-26140.html" rel="nofollow noopener" target=_blank>Sunflower Health Plan, KMAP Bulletin 26140 (updated), dated 08/31/26</a></li>
<li><a href="https://www.uhcprovider.com/en/health-plans-by-state/kansas-health-plans/ks-comm-plan-home/ks-cp-news.html" rel="nofollow noopener" target=_blank>UnitedHealthcare Community Plan of Kansas, Bulletins and Newsletters</a></li>
<li><a href="https://www.ksrevisor.gov/statutes/chapters/ch74/074_053_0062.html" rel="nofollow noopener" target=_blank>K.S.A. 74-5362, licensed clinical psychotherapist title</a></li>
<li><a href="https://www.ksrevisor.gov/statutes/chapters/ch74/074_053_0010.html" rel="nofollow noopener" target=_blank>K.S.A. 74-5310, psychologist licence requirements</a></li>
<li><a href="https://www.ecfr.gov/current/title-42/section-438.402" rel="nofollow noopener" target=_blank>42 CFR 438.402, appeal deadlines</a></li>
</ol></section>
<p class=disclaimer>Sources read October 17, 2026. General information, not legal or medical advice. Your KanCare plan decides what it accepts.</p>
<div class=cta-section>
<h2>Diagnosis Sorted? Start In-Home ABA in Kansas</h2>
<p>Free benefits check. BCBA-led, in-home, KanCare accepted.</p>
<a href="https://www.achievingstarstherapy.com/contact" class=cta-button>Check Your Coverage</a>
<div class=cta-grid>
<div class=cta-item><div class=cta-item-label>Call</div><div class=cta-item-value><a href=tel:8336663115>(833) 666-3115</a></div></div>
<div class=cta-item><div class=cta-item-label>Email</div><div class=cta-item-value><a href="mailto:info@achievingstarstherapy.com">info@achievingstarstherapy.com</a></div></div>
<div class=cta-item><div class=cta-item-label>Ages</div><div class=cta-item-value>18 months to 15 years</div></div>
</div>
</div>
</div></div>
</body>
</html>