National Academies Report Calls for Military to Cover Applied Behavior Analysis as a TRICARE Basic Benefit
WASHINGTON, Sept. 22, 2025 /PRNewswire/ — The National Coalition for Access to Autism Services (NCAAS) today hailed the release of the National Academies of Sciences, Engineering, and Medicine’s comprehensive report confirming what military families, autism care providers, and advocates have long argued: Applied Behavior Analysis (ABA) is a medically necessary service for many autistic individuals and should be treated as a standard benefit by TRICARE, the military services’ healthcare program for active-duty service members and veterans.
The 336-page congressionally mandated study, The Comprehensive Autism Care Demonstration: Solutions for Military Families, rejects the Department of Defense’s prior conclusions about ABA and calls on TRICARE to recognize ABA as a core benefit for military families.
“This report is a watershed moment for our military families,” said Mike Moran, chairman of NCAAS. “The National Academies recommended that the Department of Defense should discontinue its current autism care program and authorize coverage of applied behavior analysis—a primary and highly personalized therapeutic approach to autism—as a basic benefit under the TRICARE program, including moving the ABA billing program off the No Government Pay List.”
TRICARE is an outlier. While nearly all commercial and self-funded employer plans, Medicaid, CHIP, FEHBP, and CHAMPVA cover ABA, TRICARE still treats it as a temporary demonstration. The National Academies study not only identifies ABA as a standard of care to address autism, but it recommends that ABA services be available to address maladaptive behaviors and activities of daily living affecting the health and well-being of children with autism, including:
- Removal of current restrictions that do not allow medically necessary ABA services in schools and other community settings for purposes of targeting behaviors and skills outside the home.
- Allowing reimbursement for higher staff-to-client ratios and crisis intervention procedures were deemed necessary by the ABA provider.
NCAAS first became concerned in 2018 about the Department of Defense’s reports to Congress questioning the efficacy of the Department’s Autism Care Demonstration, which were predicated on conclusions drawn from the DoD’s incorrect use of a widely used assessment tool and TRICARE’s misuse of patient data in the Autism Care Demonstration—conclusions that have been invalidated by the National Academies report. NCAAS raised these concerns with Pentagon officials and the Congressional Armed Services Committees, which led to Congress directing National Academies to undertake the independent analysis that it issued this month.
“For years, military families were told that the Defense Health Agency’s data showed ABA was ineffective. The National Academies found those conclusions were based on misused measures that could never capture children’s real progress,” said Julie Kornack, an NCAAS board member. “Now we have the definitive word: the problem was not ABA, but the way TRICARE measured it. Military families deserve better, and this report makes clear the system must change.”
About NCAAS
The National Coalition for Access to Autism Services (NCAAS) is a national nonprofit representing providers and advocates of evidence-based autism treatment. NCAAS members serve tens of thousands of families affected by autism spectrum disorder and work with TRICARE, Medicaid, Federal Employees Health Benefits Program (FEHBP), CHAMPVA (the Department of Veterans Affairs healthcare program), the federal Children’s Health Insurance Program (CHIP), and commercial insurers. NCAAS members serve a broad range of patients of all ages with varying degrees of autism, although most patients are children. NCAAS represents large, medium, and small business providers of applied behavior analysis (ABA), the primary therapeutic treatment for children diagnosed with autism.
Contact:
Cooper Rumrill
(202) 980-4968
[email protected]
View original content:SOURCE National Coalition for Access to Autism Services
