In most cases, yes. Pennsylvania's Act 62 requires state-regulated group health plans (51+ employees) to cover ABA therapy for autism, performed by a licensed BCBA, with no visit limits, for members up to age 21. Cigna covers ABA therapy when medically necessary. Confirm your specific plan with a Verification of Benefits before starting.
Pennsylvania's Autism Insurance Act (Act 62), signed into law in 2008, requires state-regulated group health insurance policies — including HMOs and PPOs — issued in Pennsylvania to groups of 51 or more employees to cover the diagnosis and treatment of autism spectrum disorder, including ABA therapy performed by a licensed BCBA. The law prohibits visit limits on autism services and covers members up to age 21. Fully-insured group plans of 51+ employees, issued in PA, are bound by Act 62. Self-funded employer plans are typically governed by federal ERISA law instead, and Act 62's state mandate does not apply to them — though many self-funded employers choose to cover ABA anyway. Cigna's own coverage policy states ABA therapy is covered for autism spectrum disorder when medically necessary, with details varying by the specific plan.
Cigna has a two-step process for ABA authorization in Pennsylvania:
Prior authorization is not required for the initial ABA assessment (CPT 97151, 97152, or 0362T) as long as it's performed by an independently licensed clinician or BCBA, and the policy covers ABA services.
After the assessment, the provider submits an ABA Prior Authorization Form with the treatment plan. Cigna recommends submitting this up to 30 days before, or within 2 weeks after, the planned start of service.
All ABA services are billed under CPT codes 97151–97158, 0362T, and 0373T, including telehealth delivery. Plan-specific questions: Cigna's Autism Care Coordinator team, 877.279.7603.
Families across Montgomery County and the surrounding Philadelphia suburbs — including Abington, Ambler, Bridgeport, Cheltenham, Conshohocken, Hatboro, Horsham, Lansdale, Narberth, Norristown, North Wales, Pottstown, Royersford, Schwenksville, Skippack, Springfield Township, and Worcester Township — ask essentially the same two questions: does Cigna cover ABA here, and who's actually taking new patients in-network. Coverage follows the statewide Act 62 rules above regardless of which of these towns you're in; what varies is provider availability, not the coverage rule. Harmony Care Finder's provider network spans this corridor, so one coverage check surfaces in-network options across whichever town is closest.
Call the member services number on your Cigna card and request a Verification of Benefits. Confirm: ABA coverage, prior authorization requirements, session caps, deductible, copay, out-of-pocket maximum. Record the date and representative's name.
Use Our Free Coverage Check →Let us check your benefits and match you with Pennsylvania providers who accept Cigna. It's free.
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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.