By October 2, 2025 (effective immediately): Billing team must update claim submission protocols and billing system rules for all Aetna ASD-related claims to reflect CPB 0648. (1) Create a covered services checklist in the billing system for ASD evaluations and treatment to include: developmental evaluation, cognitive/adaptive assessments, speech-language pathology evaluation, audiological evaluation, genetic testing (karyotype, fragile X), EEG (when clinically indicated), PT/OT evaluation, pharmacotherapy for co-morbidities, behavior modification, intensive educational interventions, and communication aids. (2) Implement a hard block or prior authorization requirement for ALL services listed in the 'Experimental, Investigational, or Unproven' section—including but not limited to: allergy testing for food sensitivities, metabolomic panels (e.g., NPDX ASD ADM Panel), biomarker testing (oxytocin, vasopressin, cytokines), genetic panels not tied to specific syndromes, heavy metals testing, micronutrient testing, neuroimaging (fMRI, PET, SPECT, MRI for diagnostic purposes), and hair/stool analysis. (3) Update encounter forms and provider reminders to alert clinicians that these experimental tests will not be covered without prior authorization. (4) Train front desk and billing staff to flag any claims containing experimental procedures and route them for denial or prior authorization review. Failure to implement these controls will result in claim denials and member complaints. Ensure providers understand that coverage is subject to specific plan exclusions noted in footnotes—many Aetna plans exclude educational services (e.g., school-based speech therapy or ABA) and communication aids, so verify member benefits before billing.