The Developmental Disabilities Mandate (PL 2009, Chapter 115) became effective in February 8, 2010 in NJ. This mandate provides coverage for certain therapies for the treatment of autism and other developmental disabilities through your health coverage, including:

  • Coverage for expenses incurred in screening and diagnosing autism or another developmental disability.
  • Coverage for expenses incurred for medically necessary physical therapy, occupational therapy and speech therapy, as prescribed through a treatment plan for autism or another developmental disability.
  • Coverage for expenses incurred for medically necessary behavioral interventions based on applied behavioral analysis (ABA) and related structured behavioral programs for the diagnosis of autism.  ABA therapy services are limited to autistic children under age 21 years and are subject to an annual dollar maximum of $36,000 per child.
  • A benefit for the Family Cost Share portion of expenses incurred for certain health care services obtained through the New Jersey Early Intervention System (NJEIS).