State-reimbursed autism therapy: seven Romanian county insurance funds have paid for no session

What the state pays for#

Since 1 October 2023 the national health insurance fund (CNAS) reimburses psychotherapy, psychological counselling and speech therapy for people diagnosed with autism spectrum disorder (in the legal text, the "national sub-programme of related services"; practices are called "providers"). At a practice with a contract, the family does not pay for the reimbursed sessions: the insurance fund gives the practice 135 lei for each 50-minute session.

The diagnosis is made by a psychiatrist or child psychiatrist, who also recommends the sessions. The fund reimburses at most 40, 42 or 44 sessions a month per patient, depending on the number of working days. The practice must hold a contract with the fund of the county where it is registered; units in the defence and public-order network contract with AOPSNAJ, a separate fund with no county.

The numbers on this page come from tables CNAS publishes for each county fund. A row shows how many people had sessions paid by that fund, so where contracted practices work, not where children live.

Seven insurance funds have paid for no session#

In all 11 CNAS reports, from the last three months of 2023 to 30 June 2026, seven county funds show zero children, zero adults and zero sessions: Bistrița-Năsăud, Botoșani, Brăila, Caraș-Severin, Covasna, Galați and Ialomița. 471,038 children and young people under 20 live in these counties, and 10,744 children have a disability certificate.

The number of counties with paid sessions rose quickly: from seven at the end of 2023 to 34 at the end of 2024. Since the first half of 2025 there have been 35; the other seven have stayed at zero.

Zero means zero in the county fund's table. It does not mean no child in the county has therapy: a child may go to a practice in another county, receive therapy at a public centre, or pay out of pocket. A practice in the county could also hold a contract with AOPSNAJ, which does not appear by county (109 children in the first half of 2026).

How many children the therapy reaches#

At the launch, the CNAS president, Andrei Baciu, said that according to the order that set up the programme, about 13,471 children and 2,660 adults could benefit; the figure does not state a period. In the whole of 2025, 4,474 children (33% of the estimate) had sessions paid, and in the first half of 2026 5,439 children (40%) and 158 adults (6%). The estimate is the institution's own; it is not a count of people with a proven entitlement.

Among counties with at least 15 children, the top ones have about four times as many children with paid sessions per 1,000 residents as the bottom ones (90th and 10th percentiles). Between Argeș and Timiș the gap is almost tenfold. Per 100 children with a disability certificate in the county, the funds paid for therapy for 18 in Argeș, 15 in Tulcea and 15 in Bihor, but for 2 in Timiș, 1 in Sibiu and 0.3 in Harghita. The numbers measure sessions reimbursed by a fund; they depend on how many contracted practices exist and where children come from.

Therapy is concentrated in a few places. Four funds (Bucharest, Argeș, Iași and Suceava) paid for 43% of the children, though 20% of the population under 20 lives in their counties. Bucharest alone has 27% of the sessions and 8.5% of the country's children and young people. Ilfov, which surrounds the capital, shows 0.2 children per 1,000, Bucharest 3.6; together the two reach 2.7. Sessions in the capital area are mostly reimbursed through the Bucharest fund.

Why zero? What is known and what is not#

The tables do not explain. What is known is who delivers the therapy: private psychology practices with a contract at the county fund. To contract, a practice files proof of provider evaluation (and accreditation where required), professional liability insurance and the certificates of its psychologists, who must be licensed members of the College of Psychologists. The psychologists need at least 40 hours of training in autism interventions or two years of experience with a recommendation from a senior psychologist.

How few the practices are shows in two counties where the fund gave numbers to the press. In Vaslui two providers had a contract in 2024 and three in 2025, all in Vaslui town: 72, then 102 children. In Olt, the fund reported in April 2025 seven providers with a contract, five of them in Slatina. The numbers the Vaslui fund gave to the news agency Agerpres match the CNAS table: 72 children in 2024, 102 children and four adults in 2025, 1,572,480 lei.

With so few practices, jumps from one period to the next can come from a single contract: Tulcea went from zero to 56 children in the first half of 2024 and reached 110 in 2025, and Constanța rose from 36 children in 2025 to 195 in the first half of 2026. The tables do not say what changed. What they do not show: whether anyone in the seven counties applied for a contract, whether a file was rejected, how many psychologists trained in autism work there, and how many children go to therapy in another county. The county funds have not been asked as of publication; they hold the answers.

Therapy does not depend on CNAS alone. In Vrancea, the child-protection directorate has records of more than 600 children with autism, while the fund paid for therapy for 11 children in 2025 and 8 in the first half of 2026; a psychologist told Agerpres that paediatric psychiatry is not reimbursed by the fund and is offered only in private practices. In Vaslui, more than 200 children with autism receive free therapy at the child-protection directorate's centres, and the county education resource centre counts about 800 children with autism among the 4,182 assessed for school placement. A parent says in the same report that they paid as much as 3,000–4,000 lei a month for therapy and that reimbursement by the fund rarely happens in practice. These numbers have different sources and units and should not be divided into one another.

A parliamentary question to the health minister in May 2026 asks why there is no national register of people with autism; this is why the page does not estimate how many children need therapy.

If your child has autism: the steps and the questions#

1. The diagnosis. It is made by a psychiatrist or child psychiatrist. Without a diagnosis there is no entry to the sub-programme.
2. The recommendation. The same doctor recommends the sessions. The fund reimburses at most 40, 42 or 44 sessions a month, by the number of working days.
3. The practice. Ask the county insurance fund for its list of practices with a contract for autism therapy (in the legal text, "related services for autism spectrum disorder"). If the list is empty, ask whether a practice in a neighbouring county can take the child: the practice's contract is with the fund of its own county, but the tables do not show whether it takes children from other counties. The norms oblige practices to respect the insured person's free choice of psychologist and provider.

Therapy can be stopped if the doctor or psychologist finds that the patient is not attending the sessions.