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INFORMATION ABOUT USING PRIVATE INSURANCE TO COVER ABA SERVICES
INFORMATION ABOUT USING PRIVATE INSURANCE TO COVER ABA SERVICES
Our behavioral services may be covered by your health insurance!
Our behavioral services may be covered by your health insurance!
Most insurance companies require a medical diagnosis from the DSM-5 of Autism (Level 1, 2, or 3) in order to cover ABA services
Ask the insurance company what, if any, documentation is needed to determine “medical necessity”
Some of the procedure codes to ask your insurance company about for behavioral services are:
0359T (behavior identification assessment)
0364T (adaptive behavior treatment by protocol)
0368T (adaptive behavior treatment with protocol modification)
0370T (family adaptive behavior treatment guidance)
Some insurance companies are covering out-of-network providers, since many do not have a sufficient number of in-network BCBAs
If your employer chooses a self-funded plan, the plan will fall under federal regulations (ERISA) and services may not be covered by your policy at all. More info on self-funded plans at https://www.autismspeaks.org/self-funded-health-benefit-plans
For more info from Autism Speaks on insurance coverage visit https://www.autismspeaks.org/health-insurance
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