The first step is to call your insurance company and ask if ABA (Applied Behavior Analysis) behavior services are covered under your plan. The CPT codes for ABA therapy are 97151, 97153, 97155 and 97156. We can also call for you.

NOTE: If your plan covers state and federal mandates, then it should cover ABA (Applied Behavior Analysis) behavioral services. However, if you have an ERISA (self funded) policy, they are not required to follow state and federal mandates. If you ask your human resources department and show them the need for these services, sometimes they can add this service to your policy.

The Developmental Disabilities Mandate (PL 2009, Chapter 115) became effective on February 8, 2010 in NJ. This mandate provides coverage for certain therapies for the treatment of autism and other developmental disabilities through your health coverage, including:

Coverage for expenses incurred in screening and diagnosing autism or another developmental disability.
Coverage for expenses incurred for medically necessary physical therapy, occupational therapy and speech therapy, as prescribed through a treatment plan for autism or other developmental disability.
Coverage for expenses incurred for medically necessary behavioral interventions based on applied behavioral analysis (ABA) and related structured behavioral programs for the diagnosis of autism.
A benefit for the Family Cost Share portion of expenses incurred for certain health care services obtained through the New Jersey Early Intervention System (NJEIS).

A treatment plan is developed with the caregivers input and sent to the insurance company for approval. Once authorisation is received the BCBA comes with the RBT staff to begin services.

Initially, the RBT will “pair” with the child and collect behavior data for the FBA (functional behavioral assessment). Pairing refers to the technician becoming a reinforcer for the client.

The Board Certified Behavior Analyst (BCBA) assigned to your child will continue to come out to your home to supervise the RBT, collaborate with caregivers, and to administer curricular assessments such as the Assessment of Basic Language and Learning Skills (ABLLS), Verbal Behavior Milestone Assessment and Placement Program (VB-MAPP) and/or Assessment of Functional Living Skills (AFLS) assessment.

Once the FBA and curricular assessments are completed, a Natural Environment Training (NET) program and Intensive Teaching at the Table (ITT) program along with a behavior intervention plan (BIP) are implemented for the child or adolescent. As the individual masters programs, training is provided to the caregivers and new goals are developed.

The continuation of these services are determined by the child’s needs, progress and insurance plan.

Contact Us

Contact Info

In-Home ABA Therapy for Children with Autism,
Serving South New Jersey

Burlington County

Camden County

Gloucester County

Cumberland County

What areas do you cover?

What’s the first step I need to take to work with you?

Which insurance providers do you work with?

Do you accept Medicaid?

How does insurance for children with ASD work?

What if I don’t have insurance?

What’s your cancellation policy?

Does my child have to have a diagnosis of Autism to be assessed by you?

I’ve got the right insurance. What happens next?

How long will it take to hear from you after I fill out the forms?

What happens at the initial assessment?

What happens after the initial assessment?

Links

Contact