In most cases, yes. Pennsylvania's Autism Insurance Act (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. Humana 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 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. Humana covers ABA therapy for autism spectrum disorder when medically necessary, with details varying by the specific plan.
Most Humana plans in Pennsylvania require prior authorization before ABA services begin:
A formal ASD diagnosis from a licensed psychologist or developmental pediatrician is required before submitting a treatment plan.
Humana typically requires a comprehensive treatment plan with measurable goals, assessment results, weekly therapy hours, and the BCBA's credentials before authorizing ABA services.
ABA services are billed under CPT codes 97151–97158, 0362T, and 0373T. Call the member services number on your Humana card to confirm your plan's specific authorization process.
Call the member services number on your Humana card and request a Verification of Benefits. Confirm: ABA coverage, prior authorization requirements, session caps, deductible, copay, and out-of-pocket maximum. Ask specifically whether your employer plan is fully-insured (covered by Act 62) or self-funded.
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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 August 2026. Coverage terms and provider availability change frequently — verify directly with your insurance carrier and the provider before scheduling.