The TRICARE Autism Care Demonstration (ACD) covers ABA services for all eligible TRICARE beneficiaries diagnosed with Autism Spectrum Disorder (ASD). The demonstration began July 25, 2014, and will continue through December 31, 2023.
ABA services require prior authorization. Authorized ABA supervisors must complete an ABA assessment, develop an individual treatment plan and supervise all services provided by assistant behavior analysts and behavior technicians. ABA supervisors must also complete outcome measures at baseline every six months.
Learn more about billing guidelines, referrals and authorizations, how to join the network and more. For questions regarding ABA services, please contact us at (866) 323-7155.
The ACD adopted the new Category I CPT codes that directly transferred from the Category III codes. Specifically, the ACD has adopted 97151, 97153, 97155 and 97156. Providers should use the approved new codes for all services provided on or after January 1, 2019.View all updates