How Many Hours of Aba Therapy does Insurance Typically Cover in Utah?
In Utah, the number of ABA therapy hours covered by insurance varies depending on the specific provider and the individual needs of the child. Based on the state’s coverage landscape, typical hour limits include:
Private Insurance Plans: These plans frequently cover up to 40 hours per week, depending on medical necessity and individual assessments.
Utah Medicaid (CHEC): Eligible children under the age of 21 can receive up to 40 hours weekly through the Children’s Health Evaluation and Care program.
Tricare: Under the Autism Care Demonstration, military families in Utah generally have a cap of 25 hours per week for active-duty dependents under age 21.
Regional differences also play a role in typical authorizations. For instance, families in Salt Lake County often see authorizations up to 40 hours per week, while Utah County typically ranges from 20 to 30 hours, and Weber County often has a 25-hour weekly cap. It is important to note that these hours are subject to diagnostic requirements, BCBA supervision, and prior authorization from the insurer.
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