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Intensive Behavioral Interventions

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. References to standard benefit plan language and coverage determinations do not apply to those clients. Coverage Policies are intended to provide guidance in interpreting certain standard benefit plans administered by Cigna Companies.

• 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

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

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