Applied Behavior Analysis

Applied Behavior Analysis (ABA) is an evidence-based therapeutic approach used to treat individuals with Autism Spectrum Disorder (ASD). TRICARE covers ABA therapy as a behavioral health benefit, recognizing it as a medically necessary treatment for eligible beneficiaries diagnosed with ASD.

TRICARE ABA coverage includes: • Assessment and diagnostic evaluation • Development of individualized treatment plans • One-on-one ABA therapy sessions • Supervision by Board Certified Behavior Analysts (BCBAs) • Parent and caregiver training • Progress monitoring and plan adjustments

Eligibility requirements: • Diagnosis of Autism Spectrum Disorder by a qualified provider • Demonstrated medical necessity for ABA therapy • Prior authorization required through regional contractor • Must use TRICARE-authorized ABA providers

ABA therapy under TRICARE: • No annual or lifetime visit caps (mental health parity) • Standard cost-sharing applies based on plan • Available through network and non-network providers • Can be combined with other therapies (speech, OT) • Periodic reassessment of medical necessity required

Finding ABA providers: • Contact your regional contractor for provider directories • Check with the TRICARE Autism Care Demonstration • BACB provider registry can identify certified analysts • Some areas may have waitlists for ABA services

Early and intensive ABA therapy has been shown to significantly improve outcomes for children with autism, making TRICARE's coverage of this service particularly valuable for military families.