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We understand that dealing with insurance can be tough, but our team is ready assist you. We collaborate with multiple insurance providers to ensure ABA therapy is both affordable and accessible.
AmeriHealth Coverage for ABA Therapy
Overview of ABA Therapy
Applied Behavior Analysis (ABA) therapy is a treatment approach primarily used for individuals with autism spectrum disorder (ASD). It focuses on improving specific behaviors and skills through positive reinforcement and systematic intervention.
Coverage Details
Eligibility: Coverage for ABA therapy is typically available for members diagnosed with ASD and other related conditions.
Provider Requirements: Services must be provided by licensed and credentialed professionals, including board-certified behavior analysts (BCBAs).
Pre-Authorization: Prior authorization may be required before initiating ABA therapy services. Members should check with their plan for specific requirements.
Service Settings: ABA therapy can be delivered in various settings, including home, school, and clinical environments.
Covered Services
Individualized treatment plans tailored to the member's needs.
Direct therapy sessions with a qualified provider.
Parent and caregiver training sessions to support skill generalization.
Ongoing assessment and modification of treatment plans based on progress.
Limitations and Exclusions
Services that are not medically necessary may not be covered.
Group therapy sessions may have different coverage criteria.
Services provided by unlicensed individuals or outside of approved settings may be excluded.
How to Access Services
Obtain a diagnosis from a qualified healthcare provider.
Contact AmeriHealth Caritas to verify coverage and obtain pre-authorization if necessary.
Choose a network provider who is qualified to deliver ABA therapy.
Schedule an initial assessment and treatment planning session.