Intensive Behavioral Interventions

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Medical Coverage Policy Effective Date ........................................ ....12/15/2019. Next Review Coverage Policy Number .................................. 0499. Intensive Behavioral Interventions Table of Contents Related Coverage Resources Overview ........................................ ...................... 1 Attention-Deficit/Hyperactivity Disorder (ADHD): Coverage assessment and Treatment General Background ........................................ ....3 Autism Spectrum Disorders/Pervasive Developmental Coding/Billing Information ..................................10 Disorders: assessment and Treatment References ........................................ ................11. INSTRUCTIONS FOR USE. The following Coverage Policy applies to health benefit plans administered by Cigna Companies. Certain Cigna Companies and/or lines of business only provide utilization review services to clients and do not make coverage determinations.

• the assessment includes the administration of a reliable and valid standardized assessment tool (e.g., Verbal Behavior Milestones Assessment and Placement Program [VB-MAPP], Vineland Adaptive Scales, Assessment of Basic Language and Learning Skills [ABLLS-R], Autism Treatment Evaluation

  Assessment, Interventions, Behavioral, Adaptive, Behavior, Intensive, Vineland, Vineland adaptive, Intensive behavioral interventions