TRICARE ABA Billing — 2026 Autism Care Demonstration (ACD) Guide

TRICARE’s Autism Care Demonstration (ACD) is the military autism benefit — separate from standard TRICARE network + separate credentialing + higher rates. ACD-approved providers must follow rigid documentation, outcome-measure reporting, and PA rules.

ACD-Specific Requirements 2026

• Separate ACD provider certification (not standard TRICARE)
• ABA claim submissions through Health Net Federal Services (west) or Humana Military (east)
• Bi-annual outcome-measure reporting (PDDBI, VABS, SRS-2)
• PA required for 97151 initial assessment + 97153/97155 treatment
• Treatment plan re-authorization every 6 months

Common ACD Denials

1. Outcome-measure reporting overdue or missing
2. Progress-note gaps (must document goal-linked progress)
3. BCBA supervision-hour documentation gaps for 97155
4. PA renewal timing missed (services delivered outside PA window)

Fix — ACD Compliance Loop

Automated 6-month outcome-measure calendar + PA renewal auto-alert 60/30/14 days out. Progress-note template ties every session to specific treatment plan goal.

Case Study

$1.04M recovered in 90 days

Free 30-day TRICARE ACD audit · Pricing 4-8%

– KD, Revenant Care