Confirm eligibility
The beneficiary needs an eligible TRICARE plan and an autism diagnosis from an approved diagnosing provider.
TRICARE and ABA
TRICARE covers qualifying ABA through the Autism Care Demonstration.
TRICARE says the demonstration covers clinically necessary and appropriate ABA for qualifying beneficiaries diagnosed with autism. Families must complete the program's enrollment, referral, and authorization steps before care begins.
Complete program requirements
Active duty families may need EFMP enrollment and ECHO registration unless a specific waiver applies.
Get referral and authorization
All ABA services under the demonstration require referral and pre-authorization.
Plan for reassessment
The provider completes an assessment, submits a treatment plan, and requests continuation on the authorization cycle.