New York runs its autism services through four separate front doors, and none of them tells you about the other three. The Department of Health looks after children under three. Your school district takes over from age three. The Office for People With Developmental Disabilities (OPWDD) handles longer-term supports. Your insurer or Medicaid pays for therapy. Families who find only one of those doors can lose time waiting for one agency to act when another could already have started. This guide walks through all four in the order New York families meet them, with the state’s own rules, timelines and phone numbers.
Screening, and who can actually diagnose autism here
Concerns usually surface at a well-child visit. The Centers for Disease Control and Prevention states that the American Academy of Pediatrics recommends developmental screening at 9, 18 and 30 months, and autism-specific screening at 18 and 24 months. New York backs this with statute: the Department of Health notes that Section 2500-J of the Public Health Law requires the Commissioner of Health to establish best practice protocols for early autism screening, incorporating AAP standards and guidelines.
The tool you are most likely to be handed is the M-CHAT-R/F, and New York’s own Clinical Practice Guideline on Assessment and Intervention Services for Young Children with Autism Spectrum Disorders, 2017 Update is specific about it: both stages matter. A score of 3 or more means the follow-up parent interview should be administered; a score of 8 or more means clinicians should skip the interview and “refer the child immediately for a diagnostic evaluation for ASD.”
A screening is not a diagnosis, and in New York not everyone can make one. The same guideline states plainly: “In New York State, licensed physicians (including psychiatrists and developmental/behavioral pediatricians) and licensed psychologists can diagnose ASD.” Behavior analysts, speech-language pathologists and school evaluators contribute assessment findings, but the diagnosis comes from a licensed physician or psychologist — which matters later, because Medicaid coverage of behavioral therapy turns on who signed the referral.
Under three: the Early Intervention Program
The Early Intervention Program (EIP) is New York’s IDEA Part C system, established in Article 25 of the Public Health Law and run by the Department of Health’s Bureau of Early Intervention. Children “must be under 3 years of age and have a confirmed disability or established developmental delay, as defined by the State,” in physical, cognitive, communication, social-emotional or adaptive development. An autism diagnosis is not required to get in, and you do not need a doctor’s referral to start.
Every county has an Early Intervention Official (EIO), the “single point of entry” for the program; the municipal and county contact list gives the address and phone number for each. In New York City the route is simpler: refer by calling 311 and asking for “Early Intervention,” or through the NYC Early Intervention Referral Portal. If a New York City child is evaluated, found not eligible and is still under three, the city offers free Early Intervention Developmental Monitoring instead.
- It costs you nothing. The EIO “is responsible for making sure that eligible children receive evaluations at no cost.” Your insurance may be billed if it is licensed or regulated by New York, but “you will not have to make out-of-pocket payments or co-payments,” and state law bars those payments from counting against your policy’s annual and lifetime caps.
- There is a legal clock. The state’s clinical practice guideline records the rule: an Individualized Family Service Plan (IFSP) “must be in place for eligible children and their families by 45 days from the child’s referral to the Early Intervention Program.”
- Services come to your child. They are delivered “to the maximum extent possible, in natural environments” — homes, libraries, child care settings — though a center-based program is possible if the parent and EIO agree and it is in the IFSP.
You also have enforceable rights, with timelines in the Department’s parent questions and answers: mediation is voluntary, free and finished within 30 days; an impartial hearing on eligibility or services is decided within 30 days; a system complaint to the Bureau of Early Intervention is answered within 60 days.
Turning three: the CPSE and preschool special education
At three, responsibility moves to your school district’s Committee on Preschool Special Education (CPSE) — but the handover is not automatic on the birthday, and the date matters. The Department of Health’s transition guidance on age eligibility sets out Public Health Law §2541: a child who “turns three years of age on or before August 31, shall, if requested by the parent, be eligible to receive EIP services contained in an Individualized Family Service Plan (IFSP) until September 1 of that calendar year,” and a child who turns three on or after September 1 “shall, if requested by the parent and if already receiving EIP services, be eligible to continue receiving EIP services until January 2 of the next calendar year.” Both options depend on the child having been found eligible for preschool special education under Education Law §4410 before the third birthday, so the CPSE referral has to come first. If your child is not yet in Early Intervention and is over two and a half, the same guidance strongly recommends contacting your district CPSE directly.
Under the Commissioner’s Regulations at 8 NYCRR §200.16, the CPSE “shall meet to review the results of the initial evaluation and develop a recommendation within 60 calendar days of the date of the receipt of consent to evaluate.” Put your referral in writing and date it.
New York City Public Schools sets out the mechanics for city families, and districts elsewhere in the state work to the same regulation: eligibility runs “during the year in which they turn three through the end of the school year in which they turn five”; the CPSE sends a packet listing approved evaluation sites for you to choose from; and after consent, “we have 60 calendar days to evaluate your child.” The initial evaluation includes a social history, a psychoeducational assessment, a classroom observation and a recent physical examination, with speech and language, occupational or physical therapy assessments and a functional behavior assessment when needed.
The city’s family guide to preschool special education confirms these services “are provided free of charge to eligible children,” and explains the three service models whose acronyms you will hear constantly:
| What it is called | What it means |
|---|---|
| Related services | Therapies that support academic goals — physical, occupational and speech and language therapy, counseling, orientation and mobility services, hearing, vision and health services. |
| Special Education Itinerant Teacher (SEIT) | A special education teacher who works with your child one-to-one or in a small group at their early childhood program, another childcare location you identify, or at home in certain situations. |
| Special Class in an Integrated Setting (SCIS) | A classroom where children with and without IEPs learn together, staffed by a special education teacher and a paraprofessional. |
A full special class, serving only students with IEPs, exists for children whose needs cannot be met in a general education or SCIS classroom. In New York City, SEIT and related services are often delivered inside a free 3-K for All or Pre-K for All class, so an IEP need not mean a separate setting.
School age: the CSE and the IEP
From kindergarten, the Committee on Special Education (CSE) takes over. Under 8 NYCRR §200.4, a referral for an initial evaluation may be made by a student’s parent among others; the evaluation “shall be completed within 60 days of receipt of consent unless extended by mutual agreement of the student’s parents and the CSE”; and for a student not previously identified as having a disability, the board of education must arrange appropriate programs and services “within 60 school days of the receipt of consent to evaluate.”
Two New York specifics catch families out. If you disagree with a district assessment, you can ask in writing for an independent educational evaluation at district expense; New York City Public Schools will either agree to pay or begin an impartial hearing. And if you place your child in a private, religious or home-school setting at your own expense but still want special education services, the city requires a written Parental Notice of Intent filed with the CSE by June 1 each year, renewed annually. There are 11 CSE/CPSE regions across the five boroughs.
OPWDD: the door that is easy to miss
OPWDD funds longer-term developmental disability supports, and autism is one of the conditions in its developmental disability category. The condition must have originated before age 22 and result in functional limitations amounting to what Mental Hygiene Law §1.03(22) still calls a “substantial handicap.” Among the supports is respite, which OPWDD describes as “an ‘indirect’ service that provides relief to people who are responsible for the primary care and support of a person with a developmental disability,” provided “in the home or out of the home, during the day, evenings or overnight.” This is a separate system from school and Early Intervention, and nobody enrolls your child automatically.
OPWDD’s eligibility fact sheet, updated February 2026, states that the local Developmental Disabilities Regional Offices (DDROs) decide whether a person has a developmental disability and that “the OPWDD eligibility process starts by contacting the OPWDD Front Door.” Determinations run through a three-step review; if the second step finds your child ineligible, the written notice must give the reason and offer a meeting with DDRO staff, a third-step review by an independent committee, and — where Medicaid-funded services were sought — a Medicaid Fair Hearing.
Gathering the paperwork is the slow part. The fact sheet asks for a psychological report including a full IQ assessment with all summary scores; an interpretive report of a standardized comprehensive assessment of adaptive behavior; a medical or specialty report supporting the diagnosis; a general medical report from the past 12 months; a social or developmental history showing the person became disabled before age 22; and a social evaluation. It names the accepted instruments, and states that abbreviated measures such as the WASI or K-BIT “are not acceptable as the only measure of intellectual functioning.”
To start, the Department of Health’s tool kit for early intervention service coordinators, revised August 2026, tells coordinators to direct parents to “call the OPWDD Info Line at 1-866-946-9733 and ask to be transferred to the Front Door Office in their county.” A service coordinator who identifies a child as potentially eligible must, with your consent, notify OPWDD’s regional office under Public Health Law §2544(2)(c) — but that notification “does not serve as a referral to OPWDD.” You still make the call yourself.
Paying for therapy
Commercial insurance. New York’s autism mandate sits at Insurance Law §§3216(i)(25), 3221(l)(17) and 4303(ee). The Department of Financial Services’ Insurance Circular Letter No. 6 (2014) explains that policies subject to those sections must cover the screening, diagnosis and treatment of autism spectrum disorder, including “680 hours of applied behavior analysis (‘ABA’) treatment per policy or calendar year per covered individual.” Since October 11, 2014, a person providing ABA, unless otherwise authorized under Education Law Title VIII, “must be either an LBA or a CBAA under the supervision of an LBA.” Because the mandate reaches policies governed by New York’s Insurance Law, ask your plan in writing whether your coverage is one of them.
Medicaid. New York State Medicaid covers ABA directly. The eMedNY Applied Behavior Analysis Policy Manual, updated October 1, 2025, states that ABA by enrolled Licensed Behavior Analysts and Certified Behavior Analyst Assistants is covered for fee-for-service and Medicaid Managed Care “members under 21 years of age with a diagnosis of Autism Spectrum Disorder (ASD) as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and/or Rett Syndrome.” The member “must be referred for ABA services by a NYS-licensed and NYS Medicaid-enrolled physician, psychologist, psychiatric nurse practitioner, pediatric nurse practitioner, or physician assistant,” and referrals last no more than two years. If a provider tells you Medicaid will not cover ABA in New York, that manual is the document to point at.
The Children’s Waiver. For children with the highest needs, New York consolidated six former waivers into a single 1915(c) Children’s Waiver, providing “a single HCBS benefit package to children meeting institutional level of care (LOC) functional criteria” with Health Home care management. An amendment effective April 1, 2026 clarified, for Environmental Modifications, that the practice of “balance billing” — asking families to fund part of the cost of a service themselves — “is prohibited under Federal and New York law.”
Early Intervention is free, and preschool and school-age services on an IEP are free. Private fees vary widely and no reliable published figure exists, so ask each provider in writing for the session rate, the cost of an initial assessment, whether supervision and parent training are billed separately, and whether they are in-network with your plan.
Checking that a provider is who they say they are
New York licenses behavior analysts through the State Education Department’s Office of the Professions, which sets out the requirements for a Licensed Behavior Analyst: a master’s or higher degree from an approved applied behavior analysis program, documented experience, an acceptable examination, child abuse training and a minimum age of 21 — with an alternative pathway for holders of the BACB’s Board Certified Behavior Analyst credential. Speech-language pathologists, occupational therapists and psychologists are licensed by the same office, and all can be checked on its public verification search. Look them up before the first appointment, not after.
The state’s clinical practice guideline is also candid about treatments marketed to autism families. It states there is “no evidence in the peer reviewed literature to support chelation for heavy metals, including mercury, as an intervention for prevention or treatment of ASD” by any route, and that families “need to be counseled regarding the potential risks of this unproven therapy.” It finds current evidence does not support hyperbaric oxygen therapy, and that stem cell therapies “are considered experimental at the time of this review and are not recommended.” If a clinic offers any of these, take the offer to your child’s doctor first.
Support and finding services near you
If a district or agency refuses something you believe your child is entitled to, New York has a federally designated watchdog: Disability Rights New York, “the Protection & Advocacy System and Client Assistance Program (P&A/CAP) for persons with disabilities in New York State,” which states that it “provides free legal and advocacy services to individuals with disabilities.”
For private and voluntary-sector services, StarzMeet’s New York listings cover 366 providers in and around New York City, among them 36 special education schools, 31 psychologists and psychiatrists, 28 adaptive swimming programs, 28 adaptive martial arts programs, 27 under ABA therapy, 27 dance and movement programs, 26 adaptive arts programs, 25 speech therapy, 23 developmental and pediatric clinics and 22 special needs camps. If you know which service you are looking for, the category pages are a faster way in — ABA therapy, speech therapy, occupational therapy and diagnostic and assessment services. The directory does not yet list providers upstate, so families in Buffalo, Rochester, Syracuse, Albany and elsewhere should start with their county Early Intervention Official on the Department of Health’s contact list and with their own district’s CPSE or CSE.
Listing details come from providers and public information; confirm availability, fees and insurance directly with each provider.
Frequently asked questions
My child is two and a half. Should I refer to Early Intervention or wait for the school district?
The Department of Health’s transition guidance strongly recommends that parents of children aged two and a half or older who are not already in Early Intervention contact their district CPSE. You can still refer to Early Intervention as well: evaluations are at no cost and an IFSP must be in place within 45 days of referral. In New York City, call 311 and ask for Early Intervention; elsewhere, call your county’s EIO.
Do we need an autism diagnosis before the school district will do anything?
No. Eligibility for Early Intervention rests on a confirmed disability or an established developmental delay, and a referral to the CPSE or CSE triggers a district evaluation rather than a demand that you supply a diagnosis. A diagnosis does matter elsewhere: Medicaid ABA requires a DSM-5 autism or Rett Syndrome diagnosis and a referral from a licensed, Medicaid-enrolled clinician.
Our insurer says it covers only a few hours of ABA a month. Is that right?
Check which law your plan is under. The Department of Financial Services circular letter describes coverage of 680 hours of ABA per policy or calendar year per covered individual under Insurance Law §§3216(i)(25), 3221(l)(17) and 4303(ee). Ask whether your policy is subject to those sections, how it counts the hours, and for any denial in writing so you can appeal.
Is it worth applying to OPWDD if my child already has therapy and an IEP?
OPWDD funds a different set of supports, respite among them, rather than duplicating school or clinical services. Eligibility takes time because of the documentation required — a comprehensive IQ assessment, a comprehensive adaptive behavior assessment and evidence the disability began before age 22 — so families often start well before they need the services. Call the OPWDD Info Line at 1-866-946-9733 and ask for your county’s Front Door Office.
Sources
- NYS Department of Health – Early Intervention Program, Parent’s Questions and Answers, Municipal/County Contacts and EIP Transition Guidance: Age Eligibility
- NYS Department of Health – Clinical Practice Guideline on Assessment and Intervention Services for Young Children with Autism Spectrum Disorders (ASD), 2017 Update
- NYS Department of Health – Early Intervention Program: Autism
- NYS Department of Health, Bureau of Early Intervention – Notification to OPWDD of a Child’s Potential Eligibility: Tool Kit for Service Coordinators (revised August 2026)
- OPWDD – Eligibility for OPWDD Services: Important Facts (February 2026), Eligibility and Referrals and Respite Services
- NYS Department of Financial Services – Insurance Circular Letter No. 6 (2014), Applied Behavior Analysis
- eMedNY – NYS Medicaid Applied Behavior Analysis Policy Manual (updated October 1, 2025)
- NYS Department of Health – Overview of the 1915(c) Children’s Waiver and 1115 Waiver and the Children’s Waiver amendment approval announcement, April 2026
- Commissioner’s Regulations 8 NYCRR §200.4 and 8 NYCRR §200.16
- New York City Public Schools – Evaluation, Committees on Special Education and the Family Guide to Preschool Special Education Services
- NYC Health – Early Intervention
- NYSED Office of the Professions – Licensed Behavior Analyst requirements and the license verification search
- CDC – Developmental Monitoring and Screening
- Disability Rights New York – About Us
Banner: AI-generated illustration; the people shown are not real and are not the providers listed.
