PA Autism Insurance Act (Act 62)
If you or someone you know is the parent of a child with autism, you should know how your child’s autism-related services may be covered by private group health insurance under Pennsylvania’s Autism Insurance Act, the Medical Assistance program or the Children’s Health Insurance Program (CHIP).
The Department of Human Services, Pennsylvania Insurance Department and the Department of State are working together to successfully implement the Autism Insurance Act (ACT 62).
The documents on this page provide important information and resources about the Autism Insurance Act, and new resources continue to be developed. We encourage you to visit this page regularly for the most up-to-date resources.
What to do if your child is Enrolled in Medical Assistance and you have concerns about Applied Behavioral Analysis
If you are having a problem getting Applied Behavioral Analysis (“ABA”) for your child that you have not been able to resolve with your Behavioral Health Managed Care Organization or the county, you may contact Jill Weaver at 717-409-3791 or ABA@pa.gov.
Pennsylvania Insurance Department-Consumer Services Line
Pennsylvania Insurance Department
1209 Strawberry Square
Harrisburg, PA 17120
Fax: (717) 787-8585
TTY/TDD: (717) email@example.com
The Department of Human Services has identified procedure codes that reflect services for the diagnostic assessment and treatment of Autism Spectrum Disorder (ASD) and may be subject to Act 62. Providers should confirm with the MA beneficiary's private health insurance which procedure codes are on their fee schedule, and check with the MA Program fee schedule or contact the appropriate MA MCOs to determine which procedure codes are on their fees schedules. The Department will continue to review procedure codes to identify additional codes that reflect services for the diagnostic assessment and treatment of ASD.