TRICARE To Temporarily Cover ABA Telehealth

Beginning on March 31, TRICARE will extend coverage for ABA telehealth therapy services for families of children with autism. The measure, which will last until May 31, will cover emergency telemedicine services during the COVID-19 pandemic.

ABA therapy is largely regarded as the gold standard for supporting the development of children with ASD. Since the TRICARE Autism Care Demonstration program started in 2014, more families now have access to this vital treatment. 

Before the amended rules, providers could not conduct ABA sessions through telehealth services. But in light of the coronavirus, officials will allow coverage so families can continue to receive ABA telehealth services. 

According to a statement from TRICARE:

“We’re working in close partnership with the Defense Health Agency to explore various approaches, including telemedicine, to ensure access to care for TRICARE beneficiaries in this current environment.

Yesterday, the Defense Health Agency announced an exception to its policy regarding the use of telemedicine capabilities for Applied Behavior Analysis (ABA) services during this COVID-19 pandemic. As a result, effective March 31, 2020 through May 31, 2020, TRICARE is permitting the unlimited use of synchronous, real-time HIPAA compliant two-way audio and video services to beneficiaries for “Parent/Caregiver Guidance” rendered by Board Certified Behavior Analysts and assistant behavior analysts.

Ensuring TRICARE beneficiaries have access to the care they need is of the utmost importance to Humana Military. TRICARE is a federal health benefit. Humana’s role in this matter is as a TRICARE contractor for the TRICARE East Region. As a TRICARE contractor, we are required to process coverage authorizations within the guidelines of TRICARE policy and based on the beneficiary’s military status. TRICARE currently covers certain telemedicine services and is actively pursuing ways to expand access during the pandemic.”

The change is indeed a welcome relief for families and providers. Initially, officials stated in a Facebook that they did not intend to expand TRICARE coverage to ABA telehealth. 

The March 18 post read:

“There has been no change in policy regarding telehealth for the at this time but we are actively evaluating the policy and should a change be made, we will make an announcement which will be posted on the TRICARE website and to ABA providers who have signed up for ACD messages.”

Additionally, TRICARE’s new rules allow therapists to provide parents of children with ASD “unlimited ABA parent training/guidance services, with or without your child present.” ABA providers will be able to:

  • Teach parents common ABA methods
  • Practice ABA techniques with other members of the family
  • Reassess targets for parents 

In the same vein, TRICARE covers additional telemedicine services for children diagnosed with autism, including:

  • Physical therapy
  • Occupational therapy
  • Speech and language therapy
  • Psychotherapy and most medical care

Dr. Krystyna Bienie, a clinical psychologist as well as a senior policy analyst at the Defense Health Agency, said that the goal of the amended Tricare rules is to “give families receiving ABA services additional support during this challenging time.” 

She added, “We hope this provision will help to reduce stress on parents and help them help their children until regular, in-person services resume.”

ABA Telehealth Services From Sandcastle Centers

In order to meet the needs of children and families during this period of social distancing, Sandcastle Centers is extending our ABA services with telehealth tools. 

You can find more information about our online ABA services in the blog or visiting our telehealth services page.

Sources
  • Bushatz, Amy. “Tricare Gives Temporary OK to Telehealth Autism Therapy.” Military.com, 30 Mar. 2020, https://tinyurl.com/yan8bacm.
  • Colburn, Russell. “TRICARE to Temporarily Cover Telehealth Support for Special Needs Children amid Coronavirus Pandemic.” WJAX, 31 Mar. 2020, https://tinyurl.com/y8c6dtbh.
  • “Home.” TRICARE,https://tinyurl.com/y7dlvflk.