Of all the challenges families affected by autism face, the financial burden might be the most daunting. Costs can include myriad therapies (OT, PT, speech, ABA), fees for private education settings or legal representation to secure appropriate public education, specialized respite care providers (a 13-year-old who took the babysitting course doesn't cut it), and last but not least - the biomedical expense. Some estimates are in the millions of dollars by the time a child with autism is an adult - which is the moment government supports fall away.  
 
Biomedical treatments shouldn't break the bank. Good providers will help you manage the cost, and insurance might cover more than you think.
 
Here are pointers that might be helpful: 
 

• Your biomedical provider should describe your child's care with the correct procedural and diagnosis codes. Insurance companies regard autism as a neurological and/or psychiatric diagnosis, so coding biomedical treatments under an autism diagnosis code would cause them to be rejected for payment.  Truthfully identifying nutrition problems (e.g., "moderate calorie malnutrition," "allergic gastritis," "failure to thrive") with the correct nutrition diagnosis codes should trigger payment. For example, a prescription for a casein-free diet will follow a diagnosis code for "history of milk allergy." These should not be coded as "autism" but as the physiological findings they actually are.
  
• Work with a licensed health care provider. Health insurers might not pay providers who aren't regulated by state laws. MDs must meet licensure requirements in all 50 states. Naturopaths are licensed in some states but not others (and there's a difference between naturopaths and Naturopathic Physicians, who have graduated from accredited schools); nutrition professionals are licensed in 45 states.  CA, CO, AZ, NJ, and WY do not license or monitor the nutrition profession.  Anyone can be a "nutritionist" in these states - buyer beware.  Well-credentialed providers who work in states without licensure often maintain a license in another state, because this permits regulation of their practice and helps insurance payment for their clients.  
  
• Be prepared to appeal your health insurer's decision on this care.  Nutrition care is often rejected outright, to discourage claimants.  If you have nutrition concerns of any nature for your child, request a written referral for nutrition assessment from your in-network pediatrician.  Attach this to your statement for the biomed/nutrition claim and submit them together to your insurance.  It must show codes for diagnosis, procedures, and location, along with your provider's license number, national provider identifier number (NPI), and tax ID number.  Making sure all these numbers are on your statement will enhance odds for coverage.  Valid nutrition concerns for a young child include poor growth pattern, rigid or self-restricted diet, eating non-food items, constipation or diarrhea, reflux, poor total food intake, vomiting, bloating, eczema from foods, and so on.
  
• Some states mandate insurance benefits for nutrition care and specialized medical foods for certain nutrition diagnoses. If your insurance provider has told you, "We don't cover nutrition care," challenge this, as it might be illegal for them to withhold nutrition care for a child under certain conditions.  Explore your benefits and your state law regarding nutrition care for children. Your child might actually meet codes that trigger payment.
  
• All states have a federally mandated Early Intervention Program, administered locally through regional agencies. The EI Program mandates in-home services for children age 0-3 regardless of income if they have any developmental, learning, or nutrition issues. Nutrition services, OT, PT, speech evaluations and care can be paid for by this program.  If you have an infant or toddler with feeding, growth, developmental, or nutrition problems, you can self-refer to this program, or ask your pediatrician or local pre-school staff how to contact your region's EI Program service provider.
  
• If there isn't a biomedical specialist in your area and you can't travel to one, engage your local in-network providers to see if they will help you with biomedical treatment. My website, http://www.NutritionCare.net, has downloadable, peer-reviewed articles you can share with your pediatrician, neurologist, or other MD providers.  (They might be hesitant to help when they don't feel adequately informed on special diets and biomedical tools.)  Check the resources and education materials sections of this site - and inform them!
  

For more information on this topic, read Judy's new book (available under Diets through the ARI online store), Special Needs Kids Eat Right: Strategies To Help Kids On The Autism Spectrum Focus, Learn, and Thrive. Judy Converse MPH RD LD is a licensed registered dietitian who has specialized in autism since 1999.