Back to Top Skip to main content Skip to sub-navigation

Comprehensive Changes to the Autism Care Demonstration

The DHA Autism Care Demonstration (ACD) manual changes were published on March 23, 2021.

Since approval, a comprehensive review of the ACD occurred to evolve the program to a beneficiary-centric model. These changes aim to improve the quality of and access to care and services, and also improve the management and accountability of both the regional contractors and ABA providers.

  • By adopting these comprehensive changes, TRICARE is working to develop a more comprehensive ACD program that addresses the needs of all beneficiaries diagnosed with ASD.
  • The comprehensive changes to TRICARE's ACD towards a truly comprehensive program that integrates all potential services for the best possible outcomes tailored to the beneficiary.
  • The ACD program changes will:
    • Move the ACD to a beneficiary-centric model to help beneficiaries reach maximum potential
    • Empower parents to have a greater role in development of the comprehensive care plan for their children
    • For new beneficiaries to the program, incorporate all medically and psychologically necessary and appropriate services into one comprehensive care plan, coordinated by an Autism Services Navigator (ASN).
      • Regular case management services remain unaffected

What's Not Changing

  • The coverage for the diagnosis of ASD
  • Referral from an eligible TRICARE-authorized provider
  • Prior authorization for services
  • ABA provider completion of assessment and treatment plan

What's Changing:

  • Autism Services Navigator (ASN) for every new ACD participant. The ASN will:
    • develop a comprehensive care plan
    • improve care transition support
    • provide greater care coordination support
  • Connection to ASD resources
  • Outcome measures -- additional measures/changes of timelines
  • Increased parental involvement/support
  • Improved utilization management
  • Revision/addition of ABS category I CPT codes
  • Improved medical coordination via medical team conferences
  • Continued parental training via telehealth beyond COVID-19
  • Removal of confirmation diagnosis requirement

DHA Webinar Series: Comprehensive Changes to the Autism Care Demonstration

Download

ACD Manual Changes Q&As

These Q&As are follow up responses to questions submitted regarding the ACD policy changes published 3/23/2021. These Q&As are for informational purposes only.

File Description
Autism Care Demonstration Policy Changes: Questions & Answers - Set 1 Topics covered in Set 1 include: - Diagnostic requirements - Behavior Technicians in the School Change - Certain Community Settings
Autism Care Demonstration Policy Changes: Questions & Answers - Set 2 Topics covered in Set 2 include: - Behavior Technician Certification - Provider Certification Requirements - Participation Agreements - Restraints - Exclusions
Autism Care Demonstration Policy Changes: Questions & Answers - Set 3 Topics covered in Set 3 include: - Referrals and Authorizations - Parent Stress Measures - Sharing of Outcome Measures Reports - Access to Care - Outcome Measures – Referrals and Authorizations
Autism Care Demonstration Policy Changes: Question & Answers - Set 4 Topics covered in Set 4 include: - Provider Education - Audits - Autism Services Navigator (ASN) - Comprehensive Care Plan (CCP) - Reimbursements - Outcome Measures – General Questions - Documentation - Place of Service (PoS)
Autism Care Demonstration Policy Changes: Question & Answers - Set 5 Topics covered in Set 5 include: - CPT Codes - General - Concurrent Billing - CPT Code T1023 - Medical Team Conference (MTC) - CPT Code 97151 - CPT Code 97155 - CPT Code 97156 - CPT Code 97157/97158 - Clinical Necessity Reviews - ABA Discharge Summary

2021 ABA Maximum Allowed ACD Rates

Download

If you are not already subscribed to GovDelivery, please use the link below to subscribe to the ACD group to receive future messages.

Subscribe to GovDelivery 

You also may be interested in...

ABA in School and Community Settings

Infographic
8/9/2021
States that TRICARE approves clinically appropriate ABA services. Links to Tricare.mil/autism.

Graphic that provides information on ABA in the school and community setting. Graphics include a family and the TRICARE logo on the bottom right of the page. Links to Tricare.mil/autism.

Recommended Content:

Comprehensive Changes to the Autism Care Demonstration | Autism Care Demonstration Toolkit

ACD Autism Services Navigator

Infographic
8/9/2021
ACD Talking points infographic

Graphic that provides information on what an ASN does. Graphic includes a picture of a parent and child, with an ASN by their side. Includes the TRICARE logo on the bottom right of the graphic.

Recommended Content:

Autism Care Demonstration Toolkit | Comprehensive Changes to the Autism Care Demonstration

Changes to ACD Talking Points

Infographic
8/9/2021
ACD Talking points infographic

Graphic that provides information on what is changing and what is staying the same with the ACD changes occurring soon. Includes graphics at the top and bottom of the page featuring families and children. The TRICARE logo is on the bottom right.

Recommended Content:

Autism Care Demonstration Toolkit | Comprehensive Changes to the Autism Care Demonstration

Comprehensive Changes to the ACD

Infographic
8/9/2021
Upcoming changes to the Autism Care Demonstration

Graphic that provides information on what is changing and what is staying the same with the ACD changes occurring soon. Includes graphics at the top and bottom of the page featuring families and children. The TRICARE logo is on the bottom right.

Recommended Content:

Autism Care Demonstration Toolkit | Comprehensive Changes to the Autism Care Demonstration

Autism Care Demonstration Policy Changes: Question & Answers - Set 5

Publication
7/30/2021

Topics covered in Set 5 include: - CPT Codes - General - Concurrent Billing - CPT Code T1023 - Medical Team Conference (MTC) - CPT Code 97151 - CPT Code 97155 - CPT Code 97156 - CPT Code 97157/97158 - Clinical Necessity Reviews - ABA Discharge Summary

Recommended Content:

Comprehensive Changes to the Autism Care Demonstration

Autism Care Demonstration Policy Changes: Question & Answers - Set 4

Publication
7/27/2021

Topics covered in Set 4 include: - Provider Education - Audits - Autism Services Navigator (ASN) - Comprehensive Care Plan (CCP) - Reimbursements - Outcome Measures – General Questions - Documentation - Place of Service (PoS)

Recommended Content:

Comprehensive Changes to the Autism Care Demonstration

Autism Care Demonstration Policy Changes: Questions & Answers - Set 3

Publication
7/14/2021

Topics covered in Set 3 include: - Referrals and Authorizations - Parent Stress Measures - Sharing of Outcome Measures Reports - Access to Care - Outcome Measures – Referrals and Authorizations

Recommended Content:

Comprehensive Changes to the Autism Care Demonstration

Autism Care Demonstration Policy Changes: Questions & Answers - Set 2

Publication
6/15/2021

Topics covered in Set 2 include: - Behavior Technician Certification - Provider Certification Requirements - Participation Agreements - Restraints - Exclusions

Recommended Content:

Comprehensive Changes to the Autism Care Demonstration

Autism Care Demonstration Policy Changes: Questions & Answers - Set 1

Publication
5/24/2021

Topics covered in Set 1 include: - Diagnostic requirements - Behavior Technicians in the School Change - Certain Community Settings

Recommended Content:

Comprehensive Changes to the Autism Care Demonstration

ACD Manual Change Webinar Recording 4 2021

Presentation
4/21/2021

A recording of the fourth webinar, presented on April 21, 2021, which provided information about ACD Manual Change

Recommended Content:

Comprehensive Changes to the Autism Care Demonstration

Other Important Changes

Presentation
4/21/2021

TRICARE ACD Manual Change Webinar Session 4: Other Important Changes

Recommended Content:

Comprehensive Changes to the Autism Care Demonstration

Applied Behavior Analysis Policy

Presentation
4/16/2021

Session Three (4/16/21): Applied Behavior Analysis Policy

Recommended Content:

Comprehensive Changes to the Autism Care Demonstration

ACD Manual Change Webinar Recording 3 2021

Presentation
4/16/2021

A recording of the third webinar, presented on April 16, 2021, which provided information about ABA Policy

Recommended Content:

Comprehensive Changes to the Autism Care Demonstration

ABA Maximum Allowed Rates Effective May 1 2021

Publication
4/13/2021

Recommended Content:

Applied Behavior Analysis Maximum Allowed Amounts | Comprehensive Changes to the Autism Care Demonstration

ABA Maximum Allowed Rates Effective August 1, 2021

Publication
4/13/2021

Recommended Content:

Applied Behavior Analysis Maximum Allowed Amounts | Comprehensive Changes to the Autism Care Demonstration
<< < 1 2 > >> 
Showing results 1 - 15 Page 1 of 2

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.