In most cases, yes. New York law requires state-regulated health plans to cover ABA therapy for autism — up to 680 hours per year, with no age restriction and no annual dollar cap. Cigna covers ABA therapy when medically necessary. Confirm your specific plan with a Verification of Benefits before starting.
New York's autism insurance mandate (effective 2011, updated 2012) requires state-regulated group and individual health policies to cover the diagnosis and treatment of autism spectrum disorder, explicitly including up to 680 hours of ABA therapy per year. There is no age restriction and no annual dollar cap. Since October 11, 2014, ABA must be provided by a Licensed Behavior Analyst (LBA), or a Certified Behavior Analyst Assistant (CBAA) under an LBA's supervision, for the service to be eligible for coverage. The mandate applies to State Employee Plans, Individual Plans, Fully Insured Plans, and Marketplace Plans regulated by New York State. Self-funded employer plans are typically governed by federal ERISA instead. Cigna's own coverage policy states ABA therapy is covered for autism spectrum disorder when medically necessary, with details varying by plan.
Cigna has a two-step process for ABA authorization in New York:
Prior authorization is not required for the initial ABA assessment (CPT 97151, 97152, or 0362T) if performed by an independently licensed clinician or BCBA/LBA, and the policy covers ABA.
After the assessment, the provider submits an ABA Prior Authorization Form with the treatment plan — recommended up to 30 days before, or within 2 weeks after, the planned start date.
New York requires the provider be a Licensed Behavior Analyst (or supervised CBAA) — confirm this credential in addition to Cigna's own network status. 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.
Call the member services number on your Cigna card and request a Verification of Benefits. Confirm: ABA coverage, the 680-hour annual allotment, prior authorization requirements, deductible, copay, out-of-pocket maximum.
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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.