Skip subpage navigation
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
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...
Publication
Apr 15, 2024
.PDF |
235.23 KB
ABA Maximum Allowed Rates Effective May 1, 2024
Publication
Jun 1, 2023
.PDF |
190.68 KB
ABA Maximum Allowed Rates Effective May 1, 2023
Article
Mar 16, 2023
TRICARE develops pilots and demonstrations to test new medical services, treatments, and approaches. These include initiatives for autism care, childbirth support, and low back pain. Certain groups have the chance to benefit from these services during an evaluation period. Results from these programs may inform future benefit changes.
Publication
Apr 26, 2022
.PDF |
172.28 KB
Topics covered in Set 2 include:
- Behavior Technician Certification
- Provider Certification Requirements
- Participation Agreements
- Restraints
- Exclusions
Publication
Apr 1, 2022
.PDF |
175.48 KB
ABA Maximum Allowed Rates Effective May 1, 2022
Infographic
Aug 9, 2021
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.
Infographic
Aug 9, 2021
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.
Infographic
Aug 9, 2021
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.
Infographic
Aug 9, 2021
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.
Publication
Jul 30, 2021
.PDF |
202.11 KB
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
Publication
Jul 27, 2021
.PDF |
196.73 KB
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)
Publication
Jul 14, 2021
.PDF |
168.73 KB
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
Publication
May 24, 2021
.PDF |
168.74 KB
Topics covered in Set 1 include:
- Diagnostic requirements
- Behavior Technicians in the School Change
- Certain Community Settings
Presentation
Apr 21, 2021
.PDF |
937.39 KB
TRICARE ACD Manual Change Webinar Session 4: Other Important Changes
Presentation
Apr 21, 2021
.MP3 |
5.61 MB
A recording of the fourth webinar, presented on April 21, 2021, which provided information about ACD Manual Change
You are leaving Health.mil
The appearance of hyperlinks does not constitute endorsement by the Department of Defense of non-U.S. Government sites or the information, products, or services contained therein. Although the Defense Health Agency may or may not use these sites as additional distribution channels for Department of Defense information, it does not exercise editorial control over all of the information that you may find at these locations. Such links are provided consistent with the stated purpose of this website.
You are leaving Health.mil
View the external links disclaimer.
Last Updated: April 15, 2024