We simplify insurance for ABA therapy
Action Behavior Centers is proud to partner with many of the largest health insurers in the states we serve. Most families find that their coverage includes ABA therapy for autism spectrum disorder (ASD), and we’re here to help guide you every step of the way.
Insurance verification
We call your insurance company to verify your child’s ABA therapy coverage, deductible information, and any out-of-pocket costs.
Pre-authorization support
If required, we submit all paperwork to your insurance provider to confirm medical necessity for ABA therapy.
Direct billing
After each ABA therapy session, we submit claims directly to your insurance company for hassle-free payment.
Cigna
Blue Cross Blue Shield TX
Ambetter from MHS
TriCare West
Magellan
Get ABA Therapy Covered by Insurance with Alpaca Health
Alpaca Health completely handles the process of dealing with insurance, so you don’t have to.
Cigna
- Cigna Healthcare of Ohio Choice Fund
- Cigna Local Plus
- GWH-Cigna Healthcare
- HMO
- HMO Open Access
- Medicare Advantage HMO
- Medicare Advantage PPO
- Open Access
- Open Access Plus
- POS
- PPO
- PPO Open Access
Cigna
- Choice Fund PPO
- *Manhattan Valley office only
- Cigna Medicare Advantage HMO
- Commercial PPO
- Commercial Plans - HMO - CIGNA HealthCare of New York, Inc.
- LocalPlus
- Commercial Plans - Open Access / POS
- Medical Network
- Commercial Plans - PPO
- Medical Network Open Access POS
- OA plus, Choice Fund OA Plus
- Medical Network POS
- Open Access Plus
- Open Access Plus (OAP)
- Open Access Plus In Network Plan
Aetna (Commercial)
- Aetna Health Network Only
- Aetna Health Network Option
- Choice POS / Choice POS II
- Choice POS II (Formerly Coventry OAP) (SOI)
- Elect Choice HMO (includes Aetna Health Funds)
- HMO / POS / EPO / PPO
- Managed Choice Open Access PPO
- Managed Choice POS
- Medicare Choice (PPO)
- Medicare Duly Prime (PPO)
- Medicare Eagle (PPO)
- Medicare Enhanced Select (PPO)
- Medicare Premier Plus (PPO)
- Medicare Prime (HMO-POS
- Medicare Value (PPO)
- Medicare Value Plus (PPO)
- National Advantage Program (NAP) PPO
- Open Access Aetna Select
- Open Access Elect Choice (includes Aetna Health Funds)
- Open Access HMO
- Open Choice PPO
- Open Choice PPO - State of Illinois (SOI)
- QPOS
- Select
- Signature Authority (ASA or SRC) PPO
- Upfront Advantage
Aetna (Commercial)
- Aetna Premier Care Network PLUS
- Aetna Whole Health/Seton Health Alliance
- Commercial HMO
- Commercial PPO
- Medicare Advantage HMO
- Medicare Advantage PPO
- NAP (National Advantage Program)
- Open Access
Find ABA Therapy Covered by Insurance Near You
Many insurance plans work across state lines, and we serve families nationwide. Select your state below to confirm network availability and learn about providers in your area. We'll verify your benefits and help you get started with personalized ABA therapy.
States We Serve
Explore our coverage areas and find providers near you
Top Cities We Serve
Quick access to our most popular locations
FAQs About ABA Insurance
Do we need a diagnosis for ABA therapy to be covered by insurance?
In most cases (with some exceptions, such as Colorado Medicaid), insurance plans require a formal diagnosis of Autism Spectrum Disorder (ASD) from a qualified provider—such as a developmental pediatrician, neurologist, psychologist, or psychiatrist—before ABA therapy can be covered. Without this diagnosis, insurers typically do not consider ABA therapy medically necessary.
Do I need a referral for ABA therapy to be covered?
Sometimes. Certain insurance plans require a referral from your child’s primary care physician or pediatrician, while others allow you to go directly to an ABA provider. We can check your specific plan’s requirements during verification of benefits.
Does ABA therapy coverage require a prior authorization?
Almost always. Prior authorization means your insurance company must review and approve the treatment plan before services can start. Our team handles this process for you, submitting the necessary clinical documentation to ensure approval.
Do I need proof of medical necessity for ABA therapy to be covered?
Yes. Insurance companies require documentation showing that ABA therapy is medically necessary for your child’s development. This is usually demonstrated through the diagnostic report and a treatment plan written by a BCBA outlining specific, measurable goals.
How long does it take for insurance to approve ABA therapy?
Approval times vary by insurer, but typically range from 1–3 weeks after all documents are submitted. Delays can occur if additional information is requested. Our team stays in close contact with your insurance to help move the process along.
Are parent/caregiver training sessions covered by insurance?
Yes, most plans include coverage for caregiver training as part of the ABA treatment program. These sessions are considered essential because progress is greatest when parents and caregivers are part of the learning process.
Does insurance cover virtual ABA therapy?
Many insurers do cover telehealth ABA sessions, especially for parent training or supervision by a BCBA. Coverage may depend on your state and specific plan. We can confirm eligibility during your benefits check.
What if my insurance doesn’t cover ABA therapy?
If your plan excludes ABA or limits coverage, we’ll walk you through alternatives—such as appealing the denial, switching to a plan with autism benefits, or exploring private pay or grant options. Some states also offer Medicaid or autism mandates that ensure ABA coverage.
Start ABA Therapy, Covered by Insurance
