Autism evaluation & treatment services

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. 


From the National Institute for Mental Health: Autism spectrum disorder (ASD) is the name for a group of developmental disorders. ASD includes a wide range, a "spectrum," of symptoms, skills, and levels of disability. People with ASD often have these characteristics: Ongoing social problems that include difficulty communicating and interacting with others. 

Services for ASD patients may include evaluation, applied behavioral analysis (ABA), psychotherapy, speech therapy, occupational therapy and physical therapy.