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Intensive Behavioral Interventions - Cigna

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.

all settings (e.g., home, school, summer camp) where treatment will occur. b) The planned intensity of treatment across all settings reflects the severity of the impairments, goals of treatment, response to treatment and specific individual variables. c) If group treatment is planned, the treatment plan must include clearly defined, measurable

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