Behavioral Health Treatment for Autism Spectrum Disorder
IEHP covers behavioral health treatment (BHT) for autism spectrum disorder (ASD). This treatment includes applied behavior analysis and other evidence-based services. This means the services have been reviewed and have been shown to work. The services should develop or restore, as much as possible, the daily functioning of a Member with ASD.
BHT services must be:
You may qualify for BHT services if:
- Medically necessary; and
- Prescribed by a licensed doctor or a licensed psychologist; and
- Approved by the Plan; and
- Given in a way that follows the Member’s Plan-approved treatment plan.
You do not qualify for BHT services if you:
- You are under 21 years of age; and
- Have a diagnosis of ASD; and
- Have behaviors that interfere with home or community life. Some examples include anger, violence, self-injury, running away, or difficulty with living skills, play and/or communication skills.
- Are not medically stable; or
- Need 24-hour medical or nursing services; or
- Have an intellectual disability (ICF/ID) and need procedures done in a hospital or an intermediate care facility.
If you recently received BHT services through the Inland Regional Center, as of 2/1/2016, IEHP will now provide these services. Based on your child's birth month, you'll get details in the mail about this major change. To learn more about the transition, watch our video "Your Autism Care Transition (from the IRC to IEHP.)"
You can call IEHP Member Services at 1-800-440-IEHP (4347) or 1-800-718-4347 for TTY users, Monday – Friday, 8:00 am to 5:00 pm if you have any questions or ask your Primary Care Provider for screening, diagnosis and treatment of ASD.
Cost to Member:
There is no cost to the Member for these services.
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