HealthChoice Autism Benefit
HB 2962, which amended Title 36 O.S. 2011, Section 6060.20, mandates coverage for applied behavior analysis. HealthChoice covers these services when performed by board-certified behavioral analysts (BCBA), board-certified assistant behavioral analysts (BCaBA) or doctoral-level psychologists.
Please note that services billed by a registered behavioral technician, or any applied behavioral analysis services performed in a school setting, regardless of provider type, are not eligible for reimbursement.
The maximum benefit for applied behavior analysis is 25 hours per week and no more than $25,000 per calendar year. A current treatment plan from the BCBA or BCaBA, which includes a script from the treating physician, is required upon receipt of the first claim each rolling year.
All plan policies, provisions, deductibles, copays and coinsurance apply.
For additional information on coverage of autism spectrum disorders, call the medical claims administrator toll-free at 800-323-4314. TTY users call 711 or toll-free 800-545-8279.