Tricare Gives Temporary OK to Telehealth Autism Therapy

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A therapist gets a boy to focus on what she wants him to do during an occupational therapy appointment.
A therapist gets a boy to focus on what she wants him to do during an occupational therapy appointment, April 14, 2014. (U.S. Army/ Photo by Sgt. William Smith)

Therapists who serve autistic Tricare users can now offer some of their services via telehealth on an emergency basis, thanks to a temporary Tricare change set to start March 31.

Applied Behavior Analysis therapy is widely considered the most effective treatment for autism and is available to Tricare users under a 2014 pilot program, known as the Autism Care Demonstration (ACD). Focused on one-on-one sessions between a therapist and child, the method teaches coping and social skills and is often offered in-home.

But Tricare rules governing the benefit prohibited providers from administering it through telehealth. This limitation to in-person therapy sparked concerns among patients and providers over increased risk of spreading or contracting the novel coronavirus, formally known as COVID-19.

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Tricare officials today announced a temporary change to that rule, allowing some telehealth ABA services through the end of May.

"Due to the spread of COVID-19, the Defense Health Agency announced March 30 Tricare will temporarily cover telehealth services for parents and caregivers in the Autism Care Demonstration," officials said in a release. "From March 31 to May 31, Tricare will temporarily cover telehealth support for applied behavior analysis parent or caregiver guidance services. This is to assist ACD beneficiaries during social distancing and the COVID-19 response."

Tricare officials had previously said in a March 18 Facebook post after a virtual town hall meeting that they planned no changes to delivery of ABA therapy during the pandemic.

"There has been no change in policy regarding telehealth for the at this time but we are actively evaluating the policy and should a change be made, we will make an announcement which will be posted on the Tricare website and to ABA providers who have signed up for ACD messages," the post stated.

Through telehealth, those providers can offer parents or caregivers "unlimited ABA parent training/guidance services, with or without your child present," the guidance states. The therapy must be provided by a board-certified behavior analyst or assistant behavior analyst, it states, and can include teaching parents or caregivers ABA techniques; practicing skills with other family members; and reviewing parent or caregiver goals.

Lorri Unumb, an autism advocate, said she is grateful for the new offering but hopes Tricare will extend it beyond just caregiver training soon.

"We are grateful that [the Defense Health Agency] has responded, and hopeful that the step that was taken today is just a first step," she told Military.com.

-- Amy Bushatz can be reached at amy.bushatz@military.com.

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This story was updated March 31 to reflect a Tricare clarification to its statement regarding unlimited ABA services. 

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