Big news from the NASEM related to ABA services covered under TRICARE

"Scientific evidence indicates that ABA is an appropriate intervention to support health outcomes of autistic individuals...We encourage [Defense Health Agency] DHA to cover ABA services as a Basic benefit under TRICARE, increase flexibility by making some currently required practices optional, and develop appropriate monitoring mechanisms to support quality services."

Here are the top 10 recommendations:

1. Approve the use of all CPT codes for ABA services
2. Establish ABA reimbursement rates consistent with other TRICARE benefits
3. Stop the requirement for a specific assessment battery (PDDBI, Vineland-3, SRS) 
4. Discontinue requirement of PSI-SF and SIPA
5. Remove restrictions on location of service (allowing for school and community service settings) 
6. Ensure polices align with generally accepted standards of care (GASC)
7. Eliminate specific requirements for caregiver training (but continue support for caregiver training as part of ABA services)
8. Permit ABA to address maladaptive behavior and activities of daily living that affect the client's health and well-being
9. Allow reimbursement for higher staff to client ratios and crisis intervention procedures 
10. Make the use of an Autism Services Navigator an optional resource for families

Download the report here!