A year on a waitlist, and nobody explains what the list is for.

By Mohamed Mohamed, PMHNP-BC · Psychiatric Mental Health Nurse Practitioner · Last updated August 30, 2026

You called about an autism evaluation for your child and were told twelve months. Maybe eighteen. The person on the phone was kind about it and could not do anything, and you hung up with a number and no explanation.

The number is usually accurate. What almost nobody explains is that Michigan has more than one evaluation pathway, they do not all have the same wait, and the long one is only strictly required for some families. That distinction is the single most useful thing to understand before you spend a year waiting.

There are two different queues

Queue one: the approved autism evaluation center

Blue Cross Blue Shield of Michigan maintains a list of Approved Autism Evaluation Centers, usually shortened to AAEC. For BCBSM and Blue Care Network members, an evaluation from one of these centers is what unlocks funding for applied behavior analysis. There are roughly eighteen of them across the whole state, they perform a long multidisciplinary evaluation, and they are the source of the year-plus figure.

We have called and asked, rather than repeating what circulates online. In mid-2026 the answer from the larger academic centers in this part of Michigan was twelve to fifteen months for an autism evaluation, with the evaluation itself running several hours.

Queue two: an independent diagnostic evaluation

A qualified, licensed clinician experienced in diagnosing autism can evaluate and diagnose outside that system, and those appointments are frequently available in weeks rather than years. A diagnosis from that route is a real diagnosis. It supports school conversations, therapy referrals, speech and occupational therapy, treatment, and your own understanding of your child.

What it does not automatically do, for a BCBSM or BCN family, is authorize ABA funding on its own. That is the whole reason the first queue exists, and conflating the two is where most of the confusion comes from.

Why the wait exists at all

It is not local mismanagement, and it is worth knowing that, because families tend to assume they are being handled badly. A 2023 survey of 111 autism specialty centers across the United States found that nearly two thirds had waits longer than four months, and around 15% were past a year or had closed their waiting lists entirely. Not one responding center could complete an evaluation in under an hour, and more than a quarter needed over eight hours per child.

Behind that sit two structural facts. There are fewer than 800 developmental-behavioral pediatricians in the country for roughly 19 million children with developmental concerns, and about 11 child and adolescent psychiatrists per 100,000 children. Reimbursement for these evaluations is poor relative to the hours they take, which is why 44% of surveyed centers do not accept Medicaid at all.

An evaluation that takes eight hours, pays badly, and can only be done by a small number of people produces a queue. That is the whole mechanism.

What the wait actually costs

This is the part that justifies doing something rather than waiting quietly.

Fewer than half of children with a documented developmental concern before age three had been evaluated by age three. The national target for children with autism receiving treatment by age four is 78%. The most recent figures had it at 48%, down from 60% five years earlier.

Meanwhile the child in front of you is not on pause. The sleep problems, the anxiety, the meltdowns after school, the eating, the attention difficulties: those are happening now, they are usually what makes daily life hardest, and none of them require a completed autism evaluation to be treated.

What you can do while you wait

Ask what the list is actually for

When you call a center, ask directly whether they are an approved autism evaluation center, and whether the wait you have been quoted is for the AAEC evaluation or for a general diagnostic appointment. Get on more than one list. Ask each one whether they will call for cancellations.

Ask your ABA provider about bridge authorization

This is the mechanism most families have never heard of. Where a child is waitlisted for an approved center, ABA can in many cases begin before that evaluation is finished, on the strength of documentation from a qualified clinician showing that the concern is established and that an evaluation is scheduled or waitlisted. Michigan guidance written for families describes exactly this route: if the AAEC wait is long, obtain a bridge evaluation so that therapy can start while you wait.

Two things to be clear about. The authorization request comes from the ABA provider, not from the evaluating clinician, and the decision belongs to your insurer. Nobody can promise you an approval. What a clinician can do is make sure the clinical case is properly made: developmental history, screening, specific observations, and the referral, written the way a reviewer needs to read it.

Gather the documentation now

Whatever route you end up on, the same material is needed. Any screening your pediatrician has already done. Early intervention records. School reports and any evaluation the district has run. A written note of what you have observed and when it started. Families who arrive with this move faster at every step.

Do not wait to treat what is treatable

School accommodations do not require a completed autism evaluation. Speech and occupational therapy usually do not either. And the co-occurring anxiety, sleep and attention problems can be assessed and treated now. A diagnostic center generally does not treat them, which is part of why the wait feels like a total stop rather than one item on a list.

Where we fit, plainly

We are not an approved autism evaluation center, and the multidisciplinary evaluation that authorizes ABA under some plans is not something we offer yet. We say so on our fees page as well, because a family should not have to work that out on the phone.

What we do is the part that is currently going undone. Autism is part of the differential in every initial evaluation we perform, at no additional charge, and our initial pediatric evaluation is $425. We provide bridge documentation for families who are waitlisted, and we treat the anxiety, sleep, attention and irritability that come alongside autism while the formal evaluation proceeds somewhere else. For adults, who sit outside all of this machinery because ABA is a pediatric benefit, we do offer a full assessment, and we wrote about what a late autism assessment involves separately.

Every fee we charge is published on the fees page, which is the source of truth if it and this article ever disagree.

Sources

• Michigan pathways, the AAEC requirement by plan type, and bridge evaluation: Insurance and Autism Evaluation Guidance Document, Michigan Innovations in Care Coordination (MPHI).
• National wait times, evaluation length and Medicaid acceptance: Kraft, Badesch, Shannon et al., Wait Times and Processes for Autism Diagnostic Evaluations: A First Report Survey of Autism Centers in the U.S., 2023.
• Workforce figures and treatment access rates: Fierce Healthcare reporting on the same survey.
• BCBSM member guidance on diagnosis and approved centers: Blue Cross Blue Shield of Michigan, What Do I Need to Know About Autism Coverage?
• Medicaid evaluation standards and the CMHSP role: Michigan Medicaid Autism Spectrum Disorder Best Practice Guidelines.
• Who may diagnose in Michigan: Autism Alliance of Michigan, Diagnosis.
• Prevalence: CDC, Data and Statistics on Autism Spectrum Disorder.

Coverage rules change. The Michigan guidance cited above was written in 2021 and remains the clearest public description of the pathways, but verify your own plan’s current requirements with your insurer before making decisions based on it.