Direct answer
OHIP covers physician and psychiatrist assessments for autism diagnosis, including developmental pediatrician consultations. Applied Behaviour Analysis (ABA), occupational therapy (OT), and speech-language pathology (SLP) are not covered by OHIP — they are funded through the Ontario Autism Program Core Clinical childhood budgets for eligible children, or paid privately.
Start with the short answer, then reveal deeper context where helpful.
OHIP funds physician-delivered assessments and medical management for autism. This includes developmental pediatrician consultations (with a referral), child psychiatrist assessments and follow-up, and medical investigations if clinically indicated (e.g., genetic testing when ordered by a physician). These OHIP-covered services support diagnosis and medical management but do not fund ongoing therapy.
The Ontario Autism Program is the primary funder for autism-specific therapies not covered by OHIP. Core clinical childhood budgets (up to $6,600–$65,000/year for children under 6) cover ABA, SLP, OT, and other evidence-based supports through approved providers. Foundational Family Services are also available at no cost while families wait.
OHIP funds physician-delivered assessments and medical management for autism. This includes developmental pediatrician consultations (with a referral), child psychiatrist assessments and follow-up, and medical investigations if clinically indicated (e.g., genetic testing when ordered by a physician). These OHIP-covered services support diagnosis and medical management but do not fund ongoing therapy.
Standalone psychoeducational assessments conducted by psychologists are not covered by OHIP, even when performed for the purpose of autism diagnosis for OAP registration. Private psychological assessments cost $2,500–$4,000 and take 4–8 hours of clinical time.
The Ontario Autism Program is the primary funder for autism-specific therapies not covered by OHIP. Core clinical childhood budgets (up to $6,600–$65,000/year for children under 6) cover ABA, SLP, OT, and other evidence-based supports through approved providers. Foundational Family Services are also available at no cost while families wait.
Currently, 69,166 children are waiting for OAP core clinical services — an average wait of 5+ years. Families waiting for OAP often pay out-of-pocket or through private insurance for ABA, SLP, and OT in the interim.
OHIP
Ontario Health Insurance Plan Schedule of Benefits — Physician Services (2024)
MCCSS
Ontario Autism Program — Eligible Services and Covered Therapies (2024)
Autism assessments through hospitals and some community agencies are OHIP-covered but have 12-24 month waits. Private assessments cost $2,500-$5,000.
Yes, OAP core clinical childhood budgets cover ABA therapy through approved providers. Learn coverage amounts, wait times, and private ABA cost alternatives.
Ontario Autism Program core clinical funding: up to $65,000/year. Ranges vary by age band and support level, from $6,600 to $65,000 annually.
Commitment to Accuracy: Our data is verified against official government reports (FAO, MCCSS), peer-reviewed scientific literature, and accessible public records. Last updated: March 24, 2026.
Written by Spencer Carroll
Founder & Autism Advocate