3 As of Feb. 1, 2022, autism services are a benefit of the Texas Health Steps-Comprehensive Care Program (CCP) for Medicaid children or youth who are 20 years old and younger and meet the criteria outlined below. This benefit includes applied behavior analysis (ABA). Autism spectrum disorder (ASD) is a condition characterized by restricted, repetitive patterns of behavior, interests, or activities and deficits in social communication and social interaction, with onset of symptoms occurring in early childhood. ABA is the scientific study of the principles of learning and behavior. Texas Medicaid acknowledges that research and clinical practices in interventions for ASD are an evolving and dynamic field. As such, documentation to support the medical need for ASD services, including ABA services, may include intervention techniques with a sound basis in discipline-specific peerreviewed literature, when available; interventions with specific applicability to If you have any questions regarding the ABA benefit or any other covered ser vices, please do not hesitate to contact your Provider Relations Representative. To become a Provider for ABA ser vices, please contact our Contracting Depar tment at 915-532-3778 or via email at Contracting_Dept@elpasohealth.com. stay informed Autism services are now covered the person’s clinical and functional profile (including comorbid conditions); and an individualized, person-centered treatment plan that aligns with the values and preferences of the person with ASD and their family. How to get ASD services El Paso Health will require authorization for all ASD services. El Paso Health will accept the Texas Standardized Form for Health Care Services or the CCP Form as a method of requesting prior authorization for ASD services. Not all services may be clinically appropriate for all people, families, or situations; El Paso Health will review these requests individually and decide based on medical necessity. Services must be evidence-based; person-centered; delivered by personnel of appropriate training and credentialing; and oriented to functional, attainable, and measurable goals. These services may include, but are not limited to, one or more of the following: ■Applied behavior analysis (ABA). ■Case management / care coordination (with parent permission). ■Early childhood intervention (ECI). ■Nutrition, when provided by a licensed dietitian. ■Occupational therapy (OT). ■Outpatient behavioral health services. ■Physician services, including medication management. ■Physical therapy (PT). ■Speech-language pathology (SLP); also called speech therapy.
RkJQdWJsaXNoZXIy ODQ1MTY=