TRICARE Extends Temporary Telehealth Support for Applied Behavior Analysis Services

3/30/2020

TRICARE is taking new steps to support family members in the Autism Care Demonstration (ACD). As of Mar. 31, 2020, TRICARE covers telehealth care for ABA parent or caregiver guidance services. This is an ongoing temporary change during the national health emergency due to the pandemic. This is to help support ACD beneficiaries during social distancing and the COVID-19 response.

Are you a parent or caregiver of a child diagnosed with autism? Is your child enrolled in ACD? If so, then you can get remote, unlimited ABA parent or caregiver support guidance services at home. Your child doesn’t need to be present. A TRICARE-authorized, board certified behavior analyst or assistant behavior analyst must provide the services.

TRICARE also covers other telehealth services for children with autism when clinically indicated. This may include:

  • Physical therapy.
  • Occupational therapy.
  • Speech and language therapy.
  • Most medical care and psychotherapy.

Through secure, two-way video conferencing, ABA providers can:

  • Teach parents or caregivers ABA techniques.
  • Practice skills with other family members.
  • Review parent or caregiver goals.

“TRICARE wants to give families receiving ABA services additional support during this challenging time,” said Dr. Krystyna Bienia, a clinical psychologist and senior policy analyst at the Defense Health Agency. “We hope this provision will help to reduce stress on parents and help them help their children until regular, in-person services resume.”

Ask your TRICARE-authorized providerAn authorized provider is any individual, institution/organization, or supplier that is licensed by a state, accredited by national organization, or meets other standards of the medical community, and is certified to provide benefits under TRICARE. There are two types of TRICARE-authorized providers: Network and Non-Network. DS if they offer telehealth services. Not all providers offer these services. Telehealth services, including ABA parent or caregiver support, aren’t appropriate for all children. Your provider can help you decide if this support is right for your child’s needs.

Your provider must use CPT Code 97156, “Family Adaptive Behavior Treatment Guidance.” The provider must submit the claim with the GT modifier.

To connect with your provider, you’ll need an audio and video-enabled computer, tablet, or smartphone. Telehealth services don’t include:

  • Audio-only conferencing.
  • Phone calls.
  • Texting.

Learn more about TRICARE and COVID-19. Stay safe and take command of your health.

This article was updated on June 4, 2020 to reflect the temporary extension of ABA telehealth services through the end of the national emergency due to the pandemic.

Last Updated 6/23/2020