In most cases, yes. Pennsylvania's autism insurance law (Act 62 of 2008) requires state-regulated health plans to cover ABA therapy for autism. UnitedHealthcare covers ABA therapy when medically necessary, usually with prior authorization. Confirm your specific plan with a Verification of Benefits before starting.
Pennsylvania's autism insurance mandate (Act 62 of 2008) requires health insurance policies issued in Pennsylvania to provide coverage for autism spectrum disorder, including ABA therapy, speech therapy, occupational therapy, and physical therapy. The law applies to fully-insured group plans of 51 or more employees. There is a $36,000 annual cap for individuals under age 21, but federal parity law (MHPAEA) may limit the enforceability of this cap for behavioral health services — confirm directly with UnitedHealthcare. Self-funded employer plans governed by federal ERISA are generally exempt from state mandates, though many cover ABA voluntarily. UnitedHealthcare covers ABA therapy for autism spectrum disorder when the plan includes the benefit and treatment is medically necessary. UHC's Autism Support Program provides dedicated care coordinators to help families navigate the authorization process.
UnitedHealthcare's process for ABA authorization in Pennsylvania:
A formal autism spectrum disorder diagnosis from a licensed psychologist, developmental pediatrician, or neurologist is required.
A comprehensive ABA assessment (CPT 97151 or 97152) must be completed by a BCBA before the treatment plan is submitted for authorization.
UHC requires prior authorization before ABA treatment begins. The BCBA submits a treatment plan with measurable goals, recommended hours, and supporting assessment data. Authorization is typically reviewed every 6 months.
Pennsylvania's largest ABA therapy markets include the Philadelphia metro (Philadelphia, Montgomery, Bucks, Chester, and Delaware counties), the Pittsburgh metro, the Lehigh Valley (Allentown, Bethlehem, Easton), and the Harrisburg/York/Lancaster corridor. Harmony Care Finder can match you with UHC-accepting ABA providers across all of these regions.
Call the member services number on your UnitedHealthcare card and request a Verification of Benefits. Confirm: ABA coverage, whether the $36,000 annual cap applies to your specific plan, 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 August 2026. Coverage terms and provider availability change frequently — verify directly with your insurance carrier and the provider before scheduling.