Autism and Autism Spectrum Disorder (ASD)

UPMC Health Plan, in accordance with the State of Pennsylvania’s Act 62 Mandate, began to cover services for Autism Spectrum Disorders effective July 1, 2009.  Autism or Autism Spectrum Disorder (ASD) is a developmental disorder that can be characterized by difficulty with social interaction, communication and unusual or repetitive behavior. Children and young adults with autism and their families benefit from early diagnosis and intervention as well as therapies or programs designed to meet the patient’s special needs.  Any of the pervasive development disorders defined in the current edition of the Diagnostic and Statistical Manual (DSM) are covered. These include autistic disorder, Asperger Syndrome, Rett Syndrome, Childhood Disintegration Disorder, and Pervasive Development Disorder (Not Otherwise Specified). 

Please see the links below regarding coverage under Pennsylvania’s Act 62 Mandate. 

If you have any further questions, please contact the UPMC Health Plan Provider Services Department at 1-866-918-1595.

State Bulletin: Structures Screening for Developmental Delays and Autism Spectrum Disorder (issued 9/8/2009)

State Bulletin: Screening for Developmental Delays and Autism Spectrum Disorder (issued 7/25/2008)

Autism Treatment Plan Guidelines