Insurance & Coverage
ABAS works with the health plans listed below. Massachusetts' ARICA law requires health insurers to cover medically necessary autism treatment, so ABA is covered when it is medically necessary and prior-authorized by your plan. Learn more at the Autism Insurance Resource Center.
Insurance networks change over time. To confirm coverage for your plan, call the member services number on your insurance card. You can also contact us and we will help you check.
How coverage works
Insurance-funded ABA follows the same path with every plan:
- A diagnosis from a qualified licensed clinician.
- Your plan's authorization for an assessment.
- An individualized treatment plan, submitted to your plan for authorization.
- Plan reviews while services continue, usually every six months.
Our intake process walks you through each step.
Fees and billing
- Our current fee schedule is available on request. Call 413-461-7120 or email info@abaswma.org.
- Your copays, deductibles, and coinsurance depend on your plan. We will explain any expected costs, including out-of-network costs, before services begin.
- MassHealth members are never billed for covered services or for missed appointments.
- We can assist with out-of-network and private pay situations.
Plan-by-plan
MassHealth (MBHP / BeHealthy Partnership)
- ABA is covered for members under 21, with no PCP referral and no copay. Authorization is handled through MBHP, a Carelon Behavioral Health company.
- MBHP member line: 1-800-495-0086, TTY 1-877-509-6981 or 711 · masspartnership.com
- BeHealthy Partnership (Health New England ACO) Member Services: 800-786-9999, TTY 800-439-2370
- Grievance and appeal contacts are on our Client Rights & Grievances page.
WellSense Health Plan
- We are in-network with WellSense Massachusetts products, including MassHealth plans and plans offered through the Massachusetts Health Connector (ConnectorCare), where the plan includes behavioral health and ABA coverage.
- Member Services: MassHealth plans 888-566-0010, Health Connector plans 855-833-8120, TTY 711 · 24-hour behavioral health line: MassHealth 888-217-3501, Health Connector 877-957-5600 · wellsense.org
- If the learner was already receiving ABA before joining a WellSense MassHealth plan, a 90-day continuity-of-care period protects ongoing services while authorizations transfer.
Health New England
- We work with HNE commercial plans and the BeHealthy Partnership (see MassHealth above).
- Member Services: the number on your insurance card · healthnewengland.org
Harvard Pilgrim Health Care
- ABA requires prior authorization through Harvard Pilgrim's Behavioral Health Department. Free language interpretation is available in more than 160 languages.
- Member Services: 888-333-4742 · harvardpilgrim.org
- Passport Connect (Choice/Choice Plus) members: benefits are administered by UnitedHealthcare. Use the member services number on your insurance card.
Optum / United Behavioral Health
- Check your behavioral health benefits at liveandworkwell.com or the member services number on your insurance card.
Blue Cross Blue Shield of Massachusetts
- Member Services: the number on your insurance card · bluecrossma.org
Tufts Health Plan
- We work with Tufts Health Together (MassHealth) and Tufts Health Direct (Health Connector) plans. ABA authorization is requested directly from Tufts Health Plan.
- Member Services for Together and Direct plans: 888-257-1985, TTY 711 · tuftshealthplan.com. The same line assists with translation.
Aetna
- Member Services: the number on your insurance card · aetna.com
Evernorth Behavioral Health (Cigna)
- Cigna members' behavioral health benefits, including ABA, are administered by Evernorth Behavioral Health.
- Member Services: the number on your insurance card · my.cigna.com
Carelon Behavioral Health
- Carelon administers behavioral health benefits for several plans, including MassHealth through MBHP. Use the member services number on your insurance card.