TRICARE Autism Care Demonstration (ACD)

Offered by U.S. Department of Defense — Defense Health Agency

TRICARE coverage pathway for clinically necessary and appropriate ABA services for qualifying family members diagnosed with autism spectrum disorder.

<p>The TRICARE Autism Care Demonstration (ACD) is a U.S. Department of Defense coverage pathway for clinically necessary and appropriate applied behavior analysis (ABA) services for qualifying TRICARE beneficiaries diagnosed with autism spectrum disorder. It is separate from the regular TRICARE medical benefit and is currently authorized through December 31, 2028.</p><h3>Who may qualify</h3><p>The child must be enrolled in a TRICARE health plan and have an ASD diagnosis from an approved diagnosing provider. For active-duty service members, the child must also be enrolled in the service branch’s Exceptional Family Member Program (EFMP) and TRICARE’s Extended Care Health Option (ECHO).</p><h3>How to start</h3><ol><li>Ask the child’s approved diagnosing provider to submit an ACD referral to the appropriate TRICARE regional contractor or US Family Health Plan provider.</li><li>Wait for pre-authorization. For a first request, the initial authorization covers the ABA assessment.</li><li>The ABA provider completes the assessment and treatment plan, then requests authorization for services.</li><li>Treatment is authorized in six-month periods. The provider requests reauthorization, and a new diagnosing-provider referral is required every two years.</li></ol><p>The authorization letter gives the family the provider contact information. If care is not offered within the applicable specialty-care access standard, contact the regional contractor. Overseas availability is limited, so families should confirm access with the TRICARE Overseas regional call center.</p><h3>Hours and cost</h3><p>Current TRICARE guidance does not set a fixed weekly-hour maximum. Weekly ABA hours are based on the individual’s clinically necessary and appropriate needs. Families pay the copayment or cost-share for their TRICARE plan; TRICARE states there is no yearly or lifetime cap on the amount of covered ABA services.</p><p><strong>Important:</strong> Coverage, authorization and provider availability vary by plan and region. Confirm current requirements and costs directly with TRICARE or the family’s regional contractor before arranging services.</p>

Eligibility

The child must be enrolled in a TRICARE health plan and diagnosed with ASD by an approved provider. Children of active-duty service members must also enroll in the service branch’s EFMP and in ECHO. Overseas access is limited and region-dependent.

How to apply

Ask the child’s approved diagnosing provider to submit an ACD referral to the regional contractor or US Family Health Plan provider. Obtain pre-authorization before ABA services. The initial authorization covers assessment; treatment is then authorized in six-month periods, with a new referral every two years.

At a glance

Funding type: insurance
Services: ABA, Family Training
A diagnosis may be required
Cost notes: Copayment or cost-share varies by TRICARE plan. TRICARE states there is no yearly or lifetime cap on the amount of covered ABA services.

Source and verification

Last source check: August 6, 2026

Check the current program details at the cited source. Eligibility, funding, availability, fees, and application steps can change.

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