Effective July 2018, children and young adults (ages 0-21) identified with behavioral health needs and/or any developmental disabilities no longer need a diagnosis of autism or any autism spectrum disorder (ASD) to qualify for treatment services.
Any licensed primary care doctor/physician, surgeon or licensed psychologist can recommend behavioral health treatment (BHT/ABA) if they deem it medically necessary for the member.
For BHT, please fax the supporting documentations such as comprehensive diagnostic evaluation, result of the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) and/or recommended treatment to L.A. Care's BHT Team at 1-213-438-5054. You can also call the BHT Team at 1-888-347-2264 if you need assistance. In addition, your L.A. Care patients can call 1-888-347-2264 as well to request information about ABA/BHT services.
The EPSDT can also detect other covered services that the member is entitled to, which include physical therapy, occupational therapy, speech and language pathology. All of these services can be requested from the member's assigned provider group (IPA/PPG).
For more information about these policies for BHT coverage (APL 18-006) or EPSDT (APL 18-007), please visit the Department of Health Care Services.