Diagnosis must come from an approved ASD-diagnosing Primary Care Manager (PCM) or specialist.
Approved PCM and specialists types:
Your child must get a referral to the ACD and a pre-authorization for all Applied Behavior Analysis (ABA) services. This is required for all TRICARE plans, including incidents where TRICARE is considered secondary (Other Health Insurance [OHI]).
Are you requesting ABA services for the first time?
You and your child’s provider team must complete four baseline outcome measures before your child can get ABA services. This will help monitor your child’s progress.
Outcome measuresYou must complete the four outcome measures every six months or every 12 months (depending on the measure). If you need assistance in finding a provider to complete the outcome measures, please contact us at (866) 323-7155.
When you get your child’s authorization notice, schedule their ABA assessment with the provider listed in the authorization. If you would like to request a different provider, please call (866) 323-7155.
Your ABA supervisor’s role
TRICARE will assign your child an ASN if they are enrolled on or after Oct. 1 2021. Your child’s ASN acts as their primary clinical advocate.
The ASN will work with you to develop your child’s Comprehensive Care Plan (CCP).
Your child’s CCP will: