Autism Spectrum Disorders

Aetna covers evaluation and diagnosis of autism spectrum disorder—including ASD‑specific developmental, cognitive and adaptive behavior evaluations, speech‑language assessment by a speech‑language pathologist, and formal audiological testing (frequency‑specific BAER or otoacoustic emissions)—but considers a broad list of other diagnostic tests (many genetic/metabolomic panels, whole‑exome sequencing, advanced neuroimaging, numerous biomarker/lab and microbiome tests) and many treatments (e.g., chelation, elimination diets, neurofeedback, acupuncture, immunoglobulin, antifungals/antivirals, most supplements and alternative therapies) experimental/investigational and not covered. Coverage requires the evaluation be performed by an appropriate certified/licensed health care professional.

"Comparative genomic hybridization (CGH) when medical necessity criteria are met (see CPB 0787)."