COVID-19 Outbreak: Using Telemedicine – Autism Care Demonstration Clarification
Friday, March 13, 2020
Note: Please see March 30 article, "Telemedicine Expanded for ABA Services"
In our March 2020 “COVID-19 Outbreak: Using Telemedicine” communication, we did not include limitations that apply specifically to applied behavior analysis (ABA) services rendered under TRICARE’s Autism Care Demonstration (ACD). The telemedicine exclusions for ABA services, outlined in the TRICARE Operations Manual, Chapter 18, Section 4, paragraph 19.0, remain in effect. We apologize for any confusion this may have caused.
The ACD does not permit for telemedicine except for the completion of outcome measures (paragraph 8.2.2). As such, telemedicine is not covered for ABA services billed under Current Procedural Terminology (CPT®) codes 97151, 97153, 97155, or 97156.
Health Net Federal Services, LLC has been in discussions with the Defense Health Agency (DHA) about whether ACD policy exceptions will be implemented in light of the COVID-19 outbreak. Should DHA make a change to policy, we will inform you as soon as possible.
We are updating our Benefits A–Z telemedicine content and our March 10 web article to specify ABA-related exclusions.
Thank you for your continued partnership in caring for our military service members, retirees and their families. For the latest information on the COVID-19 outbreak, visit www.cdc.gov/COVID19.
CPT® is a registered trademark of the American Medical Association. All rights reserved.