This is a deliberately short guide, because ComPsych publishes very little that an ABA intake team can rely on — and saying so plainly is more useful than padding the page. ComPsych is best known as the largest employee assistance program vendor in the country, operating under the GuidanceResources brand. But its own product taxonomy is “Behavioral Health Programs (Employee Assistance Programs [EAP] & Managed Care Solutions),” and that second half is where the risk lives: on some employer plans, ComPsych is not just the EAP, it is the behavioral health network the member has to use to get the in-network benefit.
For an ABA practice the whole value of knowing ComPsych is in the boundary. An EAP is a short-course counseling benefit with a session cap and no ABA in it; a ComPsych-administered behavioral health network means the family’s ABA hours have to come through a network your clinicians may not be in. Confusing the two costs a family weeks. Everything below is aimed at telling them apart fast.
The signal is a mismatch inside one plan document. Here is a real one: a 2024 employer Summary of Benefits and Coverage for an “Anthem BCBS EPO” plan lists ordinary medical benefits throughout — and then, in the mental health, behavioral health and substance use row, carries its own phone number, its own registration instructions (“login to www.guidanceresources.com, click Register and use the Org Web ID”) and the limitation “Provider must be in the ComPsych network to receive the network provider benefit.” The card says Anthem. The behavioral health network is ComPsych’s. That is the carve-out, in writing, in the plan’s own federally required summary.[6][5]
Distinguishing the EAP role from the network role is the second half of the job, and the EAP has a recognizable shape. ComPsych’s own EAP Summary of Benefits and Coverage describes a plan with a $0 deductible, no out-of-pocket expenses, no out-of-network coverage at all, and “a limited number of sessions per issue per year” for mental/behavioral health outpatient services — with inpatient care, specialists, physicians/psychiatrists and psychological testing all listed as services the plan does not cover. A benefit with those features is an EAP. It is not where ABA hours come from, and an EAP authorization number is not an ABA authorization.[6][5]
guidanceresources.com, an “Org Web ID,” or the GuidanceResources name anywhere on the card or benefits portal means ComPsych is involved. It does not by itself tell you in which role.[6][5]
A dedicated mental health line that is not the medical member-services number is the carve-out tell, exactly as with any other administrator.[6][5]
Language like “provider must be in the ComPsych network to receive the network provider benefit” means ComPsych is administering the ongoing behavioral health benefit, not just triage.[6][5]
A stated session limit with no deductible and no out-of-network benefit is the EAP. Ask explicitly: “Is this the EAP, or the health plan’s behavioral health benefit?”[6][5]
An EAP is usually not a medical-plan service type and may not surface in an eligibility response at all. A ComPsych-administered behavioral health benefit may surface as mental health service types under a different plan identifier than the medical benefits. Either way, treat a thin or absent behavioral health segment as a prompt to call the number on the card, not as a coverage answer.[6][5]
The honest inventory is short. ComPsych publishes network participation requirements, a prospective-provider interest form, and marketing descriptions of its programs. It does not publish an ABA medical-necessity policy, an ABA authorization form, a provider manual, a fee schedule or a payer ID on any page reachable without a login. Its public behavioral health page describes 24/7/365 access to clinical experts, in-person and telehealth counseling through its network, case management and care coordination — and does not mention autism or applied behavior analysis at all.[4][1][3]
The one published standard that directly affects an ABA staffing model is the credentialing bar, and it is worth reading carefully: a minimum of a master’s-level degree in a behavioral health related field, at least three years post-graduate experience, a current state license or certification at the highest level available in that state, current malpractice insurance of $1 million per occurrence / $3 million aggregate, and a doctorate for all psychologists. A behavior technician does not clear that bar, and a newly certified BCBA may not clear the three-year requirement. Whether ComPsych rosters technicians under a credentialed analyst the way Carelon and Magellan do is not published — ask before you assume your delivery model fits.[4][1][3]
The provider side of ComPsych is a login-gated Provider ResourceCenter. Network applications start with the Prospective Provider Interest Form, processed in the order received, with status questions directed to providerrecruitment@compsych.com. There is no public authorization or claims documentation behind the front door.[4][1][3]
Because nothing is published, the routing has to come from the call. A workable script, in order:[5][6]
“Is this the EAP, or the behavioral health benefit under the medical plan?” Get the answer named, because the EAP has a session cap and excludes the services ABA depends on.[5][6]
The answer is either ComPsych or the medical carrier. If it is the medical carrier, stop — build the file against that carrier’s published ABA policy and use the relevant guide in this directory.[5][6]
ComPsych does not publish ABA criteria, so ask for the criteria by name and request a copy in writing. A denial you cannot read the standard for is a denial you cannot appeal well.[5][6]
A ComPsych-network requirement in the plan document means an out-of-network ABA agency may have no benefit at all on an EPO-style plan. Confirm network status, or a single-case agreement, before you schedule.[5][6]
The clinical policy above is national, but three state-level layers change what a family's card actually buys: the state autism mandate (what fully-insured plans must cover), the carrier's state Medicaid plans (which follow the state Medicaid rules, not this commercial policy), and plan funding type (self-funded ERISA plans can carve benefits differently). Here's the picture in the states we cover:
Fully-insured ComPsych plans issued in Georgia sit under the state mandate above. State Medicaid baseline: Georgia Medicaid guide →
Fully-insured ComPsych plans issued in North Carolina sit under the state mandate above. State Medicaid baseline: North Carolina Medicaid guide →
Fully-insured ComPsych plans issued in Indiana sit under the state mandate above. State Medicaid baseline: Indiana Medicaid (IHCP) guide →
Fully-insured ComPsych plans issued in Virginia sit under the state mandate above. State Medicaid baseline: Virginia Medicaid (DMAS) guide →
Fully-insured ComPsych plans issued in Tennessee sit under the state mandate above. State Medicaid baseline: TennCare (Tennessee Medicaid) guide →
Fully-insured ComPsych plans issued in Ohio sit under the state mandate above. State Medicaid baseline: Ohio Medicaid guide →
Fully-insured ComPsych plans issued in New Jersey sit under the state mandate above. State Medicaid baseline: NJ FamilyCare (New Jersey Medicaid) guide →
Fully-insured ComPsych plans issued in Maryland sit under the state mandate above. State Medicaid baseline: Maryland Medicaid (Medical Assistance) guide →
Fully-insured ComPsych plans issued in Colorado sit under the state mandate above. State Medicaid baseline: Health First Colorado (Colorado Medicaid) guide →
Fully-insured ComPsych plans issued in Utah sit under the state mandate above. State Medicaid baseline: Utah Medicaid guide →
Fully-insured ComPsych plans issued in Arizona sit under the state mandate above. State Medicaid baseline: AHCCCS (Arizona Medicaid) guide →
Fully-insured ComPsych plans issued in New York sit under the state mandate above. State Medicaid baseline: New York Medicaid (NYS DOH / eMedNY) guide →
Fully-insured ComPsych plans issued in New Mexico sit under the state mandate above. State Medicaid baseline: New Mexico Medicaid (Turquoise Care) guide →
Fully-insured ComPsych plans issued in Missouri sit under the state mandate above. State Medicaid baseline: MO HealthNet (Missouri Medicaid) guide →
Fully-insured ComPsych plans issued in Texas sit under the state mandate above. State Medicaid baseline: Texas Medicaid (THSteps-CCP) guide →
Fully-insured ComPsych plans issued in Massachusetts sit under the state mandate above. State Medicaid baseline: MassHealth (Massachusetts Medicaid) guide →
Fully-insured ComPsych plans issued in Florida sit under the state mandate above. State Medicaid baseline: Florida Medicaid — Behavior Analysis Services (AHCA) guide →
Fully-insured ComPsych plans issued in Kansas sit under the state mandate above. State Medicaid baseline: KanCare (Kansas Medicaid) guide →
Fully-insured ComPsych plans issued in Nebraska sit under the state mandate above. State Medicaid baseline: Nebraska Medicaid (Heritage Health) guide →
Fully-insured ComPsych plans issued in Idaho sit under the state mandate above. State Medicaid baseline: Idaho Medicaid guide →
Fully-insured ComPsych plans issued in Iowa sit under the state mandate above. State Medicaid baseline: Iowa Medicaid (IA Health Link) guide →
Fully-insured ComPsych plans issued in Oklahoma sit under the state mandate above. State Medicaid baseline: Oklahoma Medicaid (SoonerCare / SoonerSelect) - Oklahoma Health Care Authority guide →
Fully-insured ComPsych plans issued in Michigan sit under the state mandate above. State Medicaid baseline: Michigan Medicaid guide →
Fully-insured ComPsych plans issued in Hawaii sit under the state mandate above. State Medicaid baseline: Hawaii Medicaid (Med-QUEST / QUEST Integration) guide →
Fully-insured ComPsych plans issued in California sit under the state mandate above. State Medicaid baseline: Medi-Cal (California Medicaid) guide →
Fully-insured ComPsych plans issued in Pennsylvania sit under the state mandate above. State Medicaid baseline: Pennsylvania Medicaid (Medical Assistance) guide →
The questions that decide whether a family can start with ComPsych, and what they have to bring. Each maps onto something intake should ask on the first call.
Not published by ComPsych — it posts no provider manual, utilization-management timeframes or ABA authorization policy outside its login — so the clock comes from the employer's plan and the law behind it. For an employer group health plan governed by ERISA the federal claims rule is the floor: a pre-service request must be decided "not later than 15 days after receipt of the claim by the plan" (one 15-day extension if more information is needed), an urgent one within 72 hours, and an urgent request to extend an approved course of treatment within 24 hours if it is made at least 24 hours before the approval runs out. A fully insured plan is also bound by its state's utilization-review law. No reauthorization lead time is published.[7][3]
Ask the plan: The ComPsych behavioral health number on the back of the member’s card, with the employer/plan sponsor name in hand — ask whether the plan is self-funded or fully insured, the decision timeframe for a non-urgent ABA request, and how far ahead of the authorization end date a continued-treatment request must be submitted; record the call reference and representative's name.
Not published. ComPsych administers benefits for employer plan sponsors and publishes no ABA medical-necessity policy, so any age bound comes from the employer’s plan document rather than from ComPsych. The first thing to settle is not the age but the benefit: an EAP is a short-course counseling allowance with a session cap per issue per year, no deductible and no out-of-network coverage, and it is not where ABA hours come from.[5][1]
Ask the plan: The ComPsych behavioral health number on the back of the member’s card — ask who authorizes applied behavior analysis, which criteria set applies, and request it in writing; network questions to providerrecruitment@compsych.com. Record the call reference and the representative’s name, because with nothing published that call is the only record you will have at appeal.
Not published. ComPsych publishes no ABA medical-necessity criteria, so there is no stated rule on how recent the ASD diagnostic evaluation must be. Whatever criteria set ComPsych applies for that client governs — ask for it by name and ask for a copy in writing, because a denial you cannot read the standard for is a denial you cannot appeal well.[3][1]
Ask the plan: The ComPsych behavioral health number on the back of the member’s card — ask who authorizes applied behavior analysis, which criteria set applies, and request it in writing; network questions to providerrecruitment@compsych.com. Record the call reference and the representative’s name, because with nothing published that call is the only record you will have at appeal.
Not published. No ComPsych document reachable without a login names who may make the ASD diagnosis. Its only published credential standard is for network participation — master’s minimum, three years post-graduate, current state license at the highest level in that state, $1M/$3M malpractice, and a doctorate for all psychologists — which governs who may join the network, not who may diagnose.[4]
Ask the plan: The ComPsych behavioral health number on the back of the member’s card — ask who authorizes applied behavior analysis, which criteria set applies, and request it in writing; network questions to providerrecruitment@compsych.com. Record the call reference and the representative’s name, because with nothing published that call is the only record you will have at appeal.
Not published. ComPsych names no required or accepted diagnostic instrument for autism anywhere in its public material.[3]
Ask the plan: The ComPsych behavioral health number on the back of the member’s card — ask who authorizes applied behavior analysis, which criteria set applies, and request it in writing; network questions to providerrecruitment@compsych.com. Record the call reference and the representative’s name, because with nothing published that call is the only record you will have at appeal.
Not published, and this is the field to nail down first. ComPsych publishes no ABA authorization policy or form, so assume authorization is required and obtain it in writing before the assessment, along with the authorization number. The prior question is which entity authorizes at all: on some employer plans ComPsych is only the EAP and the medical carrier authorizes ABA, and on others the plan document requires the provider to be in the ComPsych network to receive the in-network behavioral health benefit. Ask “is this the EAP, or the behavioral health benefit under the medical plan?” and “who authorizes applied behavior analysis?” before anything else — and get the network answer before the clinical one, because an EPO-style plan may leave an out-of-network agency with no benefit.[6][5][1]
Ask the plan: The ComPsych behavioral health number on the back of the member’s card — ask who authorizes applied behavior analysis, which criteria set applies, and request it in writing; network questions to providerrecruitment@compsych.com. Record the call reference and the representative’s name, because with nothing published that call is the only record you will have at appeal.
Not published for ABA. ComPsych’s public behavioral health page advertises in-person and telehealth counseling through its network but says nothing about applied behavior analysis or which ABA codes may be delivered remotely.[1]
Ask the plan: The ComPsych behavioral health number on the back of the member’s card — ask who authorizes applied behavior analysis, which criteria set applies, and request it in writing; network questions to providerrecruitment@compsych.com. Record the call reference and the representative’s name, because with nothing published that call is the only record you will have at appeal.
Not published. ComPsych posts no coordination-of-benefits procedure, claims manual or payer ID outside its login, so which plan pays first and what a secondary claim must carry come from the employer's plan document. One boundary is published: a ComPsych EAP is a separate, session-capped benefit ("a limited number of sessions per issue per year") with no out-of-network coverage — it is not a second layer of ABA coverage to coordinate.[3][5]
Ask the plan: The ComPsych behavioral health number on the back of the member’s card — ask whether ComPsych or the other plan is primary for ABA when the child has a second plan (the other parent's plan, Medicaid, TRICARE), whether a secondary claim needs the primary EOB, and whether authorization is still required when ComPsych is secondary; record the call reference.
Coverage decides whether ComPsych pays. These decide whether the claim survives: how sessions must be staffed and supervised, what may be billed concurrently, the per-day ceilings, who signs the note, where the service is payable, and whose NPI the claim goes out under.
Not published. ComPsych publishes network participation requirements but no ABA supervision standard, provider tier or ratio. Its credentialing floor is a minimum master’s-level degree in a behavioral health related field, at least three years post-graduate experience, and a current state license or certification at the highest level available in that state — which a behavior technician does not meet, and which a newly certified BCBA may not meet either. Whether ComPsych rosters technicians under a credentialed analyst the way Carelon and Magellan do is not published.[4][1]
Ask the plan: The ComPsych behavioral health number on the back of the member’s card — ask who authorizes applied behavior analysis, which criteria set applies, and request it in writing; network questions to providerrecruitment@compsych.com. Record the call reference and the representative’s name, because with nothing published that call is the only record you will have at appeal.
Not published. ComPsych publishes no ABA authorization form, provider manual, fee schedule or claims documentation on any page reachable without a login, so there is no stated rule on billing two ABA codes for the same clock time.[3][1]
Ask the plan: The ComPsych behavioral health number on the back of the member’s card — ask who authorizes applied behavior analysis, which criteria set applies, and request it in writing; network questions to providerrecruitment@compsych.com. Record the call reference and the representative’s name, because with nothing published that call is the only record you will have at appeal.
Not published. ComPsych publishes no ABA fee schedule, unit ceiling or hour band. The only quantitative limit it does publish belongs to the EAP, not to ABA: “a limited number of sessions per issue per year” with a $0 deductible and no out-of-network coverage. An EAP session allowance is not an ABA authorization, and families frequently relay one as the other.[5][1]
Ask the plan: The ComPsych behavioral health number on the back of the member’s card — ask who authorizes applied behavior analysis, which criteria set applies, and request it in writing; network questions to providerrecruitment@compsych.com. Record the call reference and the representative’s name, because with nothing published that call is the only record you will have at appeal.
Not published. There is no ComPsych provider manual, documentation standard or session-note specification reachable without a login.[3]
Ask the plan: The ComPsych behavioral health number on the back of the member’s card — ask who authorizes applied behavior analysis, which criteria set applies, and request it in writing; network questions to providerrecruitment@compsych.com. Record the call reference and the representative’s name, because with nothing published that call is the only record you will have at appeal.
Not published. ComPsych’s public behavioral health page describes 24/7/365 access to clinical experts, in-person and telehealth counseling through its network, case management and care coordination — and does not mention autism or applied behavior analysis at all, let alone payable settings. The setting question that does bite is network rather than place: an employer plan document saying “provider must be in the ComPsych network to receive the network provider benefit” can leave an out-of-network ABA agency with no benefit at all on an EPO-style plan.[1][6]
Ask the plan: The ComPsych behavioral health number on the back of the member’s card — ask who authorizes applied behavior analysis, which criteria set applies, and request it in writing; network questions to providerrecruitment@compsych.com. Record the call reference and the representative’s name, because with nothing published that call is the only record you will have at appeal.
ComPsych’s published network participation requirements set a floor of a master’s-level degree in a behavioral health related field, three years post-graduate experience and a current state license at the highest level in that state — which a behavior technician does not meet. ComPsych does not publish whether technicians may be rostered under a credentialed analyst, or whose NPI an ABA claim must carry.[4]
Ask the plan: ComPsych provider recruitment (providerrecruitment@compsych.com) or the ComPsych behavioral health number printed on the member’s card — ask specifically whether technician-delivered 97153 is payable and under whose NPI.
ComPsych does not publish an ABA policy, so there is no honest general answer. ComPsych administers benefits for employer plan sponsors; whether ABA is covered, and whether ComPsych or the medical carrier authorizes it, is set by the employer’s plan. Ask on the benefits call whether you are being quoted the EAP or the health plan’s behavioral health benefit, and who authorizes applied behavior analysis.
Both, depending on the client. Its own product taxonomy is “Behavioral Health Programs (Employee Assistance Programs [EAP] & Managed Care Solutions).” Some employer plan documents go further and require the provider to be in the ComPsych network to get the in-network behavioral health benefit — that is the administrator role, not the EAP role.
No. ComPsych’s own EAP Summary of Benefits and Coverage describes a limited number of sessions per issue per year with no out-of-network coverage, and lists inpatient care, specialists, physicians/psychiatrists and psychological testing among the services the EAP does not cover. Treat an EAP allowance as short-course counseling, not as an ABA authorization.
Its published network participation requirements are a minimum master’s-level degree in a behavioral health related field, at least three years post-graduate experience, a current state license or certification at the highest level in that state, malpractice insurance of $1 million per occurrence / $3 million aggregate, and a doctorate for all psychologists (DEA registration for MDs). Whether behavior technicians can be rostered under a credentialed analyst is not published.
ComPsych does not publish one. Because it administers benefits for many different plan sponsors, get the payer ID, claims address and timely-filing window from the plan or from the ComPsych number on the back of the card, and record them with the authorization number.
Payer policies change frequently and vary by plan, state, and funding type. This guide was compiled from the sources above and last reviewed September 2026; it is general information, not billing, legal, or clinical advice. Always verify current requirements against the payer's live policy and a benefits check for the specific member.
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