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Does Blue Cross Blue Shield Cover ABA Therapy?

Yes, Blue Cross Blue Shield covers Applied Behavior Analysis (ABA) therapy for children under 18. Read on to learn about the provider's autism therapy coverage.

steven zauderer
Steven Zauderer
August 28th, 2022

Blue Cross Blue Shield Autism Coverage

bluecrossblueshield aba therapy coverage

Yes, Blue Cross Blue Shield insurance covers the costs of ABA therapy. Most Blue Cross Blue Shield plans cover the costs of services which treat autism for children under the age of 18. These plans include:

  1. Fully Insured Plans (FEP)
  2. Administrative Services Only (ASO)

Benefits of Blue Cross's behavioral therapy coverage

Here are some common autism benefits covered by Blue Cross:

  1. Applied Behavior Analysis (ABA) therapy
  2. Occupational, speech, and physical therapy
  3. Nutritional counseling

Some treatment for autism could be fully or partially covered by Blue Cross depending on your individual plan.

Some employers are able to personalize the programs they provide, and they could alter which benefits are included in your insurance plan.

The most important thing your family could do before receiving treatment services is to check your insurance coverage.

ABA therapy is costly if paid out-of-pocket, so make sure to confirm with your insurance provider that they can cover costs either partially or fully.

Blue Cross needs to receive a request from members which is sent by the ABA therapy provider. In the pre-authorization procedure, the first step will be to confirm if:

  1. The provider is qualified to provide ABA therapy.
  2. The member has ABA therapy coverage.
  3. The initial therapy plan meets is medically necessary for the child.
  4. The member has been diagnosed with autism by a certified diagnostician.

We're Striving To Make A Difference

Our team of over 170 board-certified ABA therapists and our leadership team strives to make a positive impact on children with autism. Contact us today to learn how ABA therapy can help your child learn behavioral skills.

References

  1. https://www.bcbs.com/
  2. https://www.bcbsm.com/index/health-insurance-help/faqs/topics/understanding-benefits/autism-faq.html
steven zauderer

CEO of CrossRiverTherapy - a national ABA therapy company based in the USA.

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