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Applied Behavior Analysis (ABA) – What you need to know about this new member benefit

Starting February 1, 2022, Parkland Community Health Plan will offer Applied Behavior Analysis (ABA) services. This benefit will be available to HEALTHfirst (STAR Medicaid) members through the Texas Health Steps-Comprehensive Care Program. See below for some common questions about these services.

ABA is a treatment that can improve social, communication, and self-regulation skills in patients with Autism Spectrum Disorder (ASD).

ASD is a condition that includes limited, repeated patterns of behavior, along with gaps in communication and social interaction. Symptoms usually start in early childhood.

Per HHSC policy, the following provider types are approved to diagnose ASD:

  • a developmental pediatrician
  • a neurologist
  • a psychiatrist
  • a licensed psychologist

Children ages 0-20 who have been diagnosed with ASD may qualify for ABA.

  • They must have been diagnosed with ASD in the last three years or have the ASD diagnosis re-confirmed within the last three years.
  • They must meet other medical criteria to qualify for ABA as described in the HHSC policy.

ABA services include

  • ABA evaluation
  • individual or group treatment
  • training for parents and caregivers
  • meetings with your care team

You cannot get ABA services through your primary care physician (PCP). However, your PCP may assist in referring to ABA services. Only qualified providers called Licensed Behavior Analysts (LBAs) can offer these services.

Do you need help finding an LBA? Call our Member Services department at 1-888-672-2277.

 

Providers called Licensed Behavior Analysts (LBAs) offer ABA services for members who qualify. LBAs can also supervise Licensed Assistant Behavior Analysts (LaBAs) and/or Behavior Technicians (BTs) in providing certain ABA services.

Please speak to your main doctor for more details or to see if you qualify.

It can improve their social, communication, and learning skills. The therapy involves treating behavior difficulties and teaching and enforcing new patterns of behavior. With this treatment, your child can learn the skills they need to function in daily life.

ABA services are available to Medicaid members at no extra cost.

Right now, this benefit is available for HEALTHfirst (STAR Medicaid) members only.

Yes, they can continue to get other medically necessary treatments.

Parents and caregivers are an important part of ABA treatment. You can help kids use what they’ve learned in therapy to function at home and in public.