Does Blue Cross Blue Shield cover ABA therapy?

March 16, 2022

Yes, ABA therapy is covered under most Blue Cross Blue Shield plans. 

Case managers at Blue Cross Blue Shield can assist you in finding an in-network provider who matches your child's needs. Most Blue Cross plans cover or assist pay for services to treat ASD for children under the age of 18. These plans include Fully Insured Plans (FEP), Administrative Services Only (ASO) plans, etc.

Benefits covered

The following are some common autism benefits covered by Blue Cross:

  • ABA therapy
  • Occupational, speech, and physical therapy
  • Nutritional counseling

Some services may be covered or partially covered depending on your individual coverage plan.  Certain employers have the ability to personalize the programs they provide. They may alter which autism benefits are included in a plan. As a result, the most important thing to do before acquiring services is to check your insurance coverage.

A request for ABA services for members must be reported to Blue Cross Blue Shield by all providers acting on behalf of the member. The first step in the pre-authorization procedure will be to confirm if:

  • Member has been diagnosed with autism by a certified diagnostician.
  • The provider is qualified to provide ABA services.
  • The member has ABA benefit coverage.
  • The initial therapy plan meets medical necessity.

Songbird provides life-changing autism care with insurance coverage from 100+ insurance companies. Reach out today to check your insurance coverage with Songbird

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