🛡 Cigna Coverage Guide — New Hampshire

Does Cigna Cover ABA Therapy in New Hampshire?

In most cases, yes. New Hampshire's autism mandate ("Connor's Law") requires health plans — including NH Medicaid — to cover ABA therapy for individuals ages 0–21. Cigna covers ABA therapy when medically necessary. Confirm your specific plan with a Verification of Benefits before starting.
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Does Cigna cover ABA therapy in New Hampshire?

New Hampshire's autism insurance mandate (RSA 417-E:2), enacted as HB 569 in 2010 and effective January 1, 2011 — known as "Connor's Law" — requires health insurance plans, including private insurance, employer-sponsored plans, and NH Medicaid, to cover ABA therapy for individuals with autism spectrum disorder ages 0 to 21. The statute lists annual dollar caps ($36,000 for ages 0–12, $27,000 for ages 12–21), but the federal Wellstone-Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) makes dollar caps, visit limits, and age limits in state mandates like this one generally unenforceable — meaning your actual plan may not apply these caps at all. Confirm directly with Cigna rather than assuming the statutory cap applies. A formal autism diagnosis from a qualified doctor — neuropsychologist, developmental pediatrician, or neurologist — plus a letter of medical necessity, is required before a treatment plan can be submitted. Cigna's own coverage policy states ABA therapy is covered for autism spectrum disorder when medically necessary, with details varying by plan.

What does Cigna require before ABA therapy starts in New Hampshire?

Cigna's process for ABA authorization in New Hampshire:

  • Diagnosis + letter of medical necessity

    A formal diagnosis from a neuropsychologist, developmental pediatrician, or neurologist — plus a letter of medical necessity — is required before submitting a treatment plan under New Hampshire's mandate.

  • Assessment (no prior auth needed)

    Prior authorization is not required for the initial ABA assessment (CPT 97151, 97152, or 0362T) if performed by an independently licensed clinician or BCBA, and the policy covers ABA.

  • Treatment plan authorization

    After the assessment, the provider submits an ABA Prior Authorization Form — recommended up to 30 days before, or within 2 weeks after, the planned start date. All ABA services are billed under CPT codes 97151–97158, 0362T, and 0373T, including telehealth. Plan questions: Cigna's Autism Care Coordinator team, 877.279.7603.

How do I verify my exact Cigna plan covers ABA therapy?

Call the member services number on your Cigna card and request a Verification of Benefits. Confirm: ABA coverage, whether any dollar cap actually applies to your plan (see the MHPAEA note above), prior authorization requirements, deductible, copay, out-of-pocket maximum.

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Frequently Asked Questions

Is there a dollar cap on ABA therapy coverage under Cigna in New Hampshire?
New Hampshire's statute lists caps of $36,000 (ages 0–12) and $27,000 (ages 12–21), but federal parity law (MHPAEA) generally makes these unenforceable. Many plans don't actually apply them — confirm directly with Cigna for your specific plan.
What kind of doctor can diagnose autism for New Hampshire's ABA mandate?
A neuropsychologist, developmental pediatrician, or neurologist. A formal diagnosis plus a letter of medical necessity from one of these specialists is required before a treatment plan can be submitted.
Does NH Medicaid cover ABA therapy too?
Yes. New Hampshire's autism mandate (Connor's Law) applies to NH Medicaid as well as private and employer-sponsored insurance, covering ABA therapy for individuals ages 0–21.

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Sources

This content is for informational purposes only and does not constitute medical, clinical, or therapeutic advice. Consult a licensed healthcare provider or Board Certified Behavior Analyst (BCBA) before making therapy decisions for your child.

Data current as of July 2026. Coverage terms and provider availability change frequently — verify directly with your insurance carrier and the provider before scheduling.