Coverage may vary by the member's plan.
Applies to
- Group HMO, EPO, POS and PPO members
- Individual MyPriority® HMO, POS and PPO members
- Self-funded plans are not mandated to provide coverage but may have a rider to cover treatment.
Priority Health Choice (Medicaid/Healthy Michigan Plan) members:
- Under the age of 5, members should be directed to their pediatrician, primary care physician, or the Community Mental Health authority for their county of residence.
- Members ages 5-18 should be directed to the appropriate staff at their school district. These members are also eligible for applied behavioral analysis (ABA) services through the community mental health setting.
Definition
From the National Institute for Mental Health: Autism spectrum disorder (ASD) is a neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave. ASD should never be referred to as a mental illness or a disease. Both autism and autism spectrum disorder (or ASD) are acceptable ways of referring to the disorder, depending on the audience and the context.
Services for ASD patients may include evaluation, applied behavioral analysis (ABA), psychotherapy, speech therapy, occupational therapy and physical therapy.
Medical policy
- Autism Spectrum Disorders - 91615