Mental Health Services

This policy covers mental health services—including individual psychotherapy, group therapy, family (conjoint) counseling, pharmacotherapy, psychiatric assessment/treatment per APA guidelines, and autism-specific ABA/EIBI per PSY301.021—with frequency and duration guided by the patient’s degree of impairment. Coverage is subject to the member’s benefit plan and state regulations (the benefit plan governs discrepancies), many specific exclusions apply, co-therapist services are payable on a single-provider basis, and the policy is inactive as of the referenced end date and must not be used for current claims adjudication.

"Applied Behavior Analysis (ABA) or Early Intensive Behavioral Intervention (EIBI) for Autism Spectrum Disorder as referenced in medical policy PSY301."

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