Find essential resources and up-to-date information regarding TRICARE's Autism Care Demonstration (ACD). The demonstration began July 25, 2014, and will continue through December 31, 2023.
TRICARE covers ABA services for all TRICARE eligible beneficiaries, enrolled in an eligible TRICARE Plan Option with ASD through the Autism Care Demonstration (ACD). ABA services require prior authorization. Authorized ABA supervisors must submit the initial assessment, treatment plan, PSI/SIPA, Vineland-3 (parent, teacher or interview form), SRS-2 (parent form) and PDDBI (parent form). Once submitted, Humana Military will review for clinical necessity and authorize six months of ABA services as appropriate based on the referral request.
Outcome measures due at baseline include the PDDBI, PSI/SIPA, Vineland-3 and SRS-2. The PDDBI and PSI/SIPA are then required every six months. The Vineland-3 and SRS-2 are required annually.
We encourage you to read and adhere to the policy outlined in the TRICARE Operations Manual (TOM), Chapter 18 Section 4. If you have questions or concerns about the policy, please contact DHA directly at email@example.com, or contact Humana Military at (866) 323-7155.
Humana Military is simplifying healthcare experiences for patients and providers. As part of those efforts, we have created a better experience for you to complete the ABA certification process and to check the status of your application! Please note that providers must be certified before they see TRICARE patients.Get certified now
The ACD adopted new Category I CPT codes. Specifically, the ACD has adopted 97157, 97158, 99366, and 99368. New codes are eligible to be used beginning August 1, 2021 when prior authorized. Please note that revisions to existing authorizations is not permitted.View all updates