If your child was recently diagnosed with autism, one of your first questions is probably about cost. Here is how insurance coverage for ABA therapy works in Tennessee, and how to find out what your plan covers.
The short answer
In many cases, yes. Most insurance plans, including Tennessee Medicaid, cover ABA therapy when three things are true:
- Your child has a diagnosis of autism.
- There is a medical need. A doctor has determined that ABA therapy is medically necessary for your child.
- There is a referral from a doctor. Most plans ask for a referral or order from your child's treating provider before therapy starts.
Does Tennessee Medicaid cover ABA therapy?
Yes. Tennessee Medicaid lists applied behavior analysis as a covered behavioral health service, based on medical necessity. Your child still needs a qualifying diagnosis and a doctor's referral, and the plan reviews the request before therapy begins. Each Medicaid plan handles the process a little differently, so the exact steps depend on your plan.
What about private insurance?
Every private plan is different. Many plans cover ABA therapy for children with an autism diagnosis, but requirements, copays, and approved hours vary. The fastest way to find out is to call the number on the back of your insurance card and ask:
- Is ABA therapy covered for my child?
- What do you need from our doctor to approve it?
- Is there a limit on hours or sessions?
How to get started in Chattanooga
At Carry On Therapy, we accept most insurance plans, including most Medicaid plans in Tennessee. We have no waitlist, so we can start right away.
We provide in-home and in-school ABA therapy in the Chattanooga area now, and our Chattanooga clinic is opening soon. A Board Certified Behavior Analyst (BCBA) designs and supervises every treatment plan. We meet families where they are.
Not sure what your plan covers? Contact Carry On Therapy. We would be glad to answer your questions.
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