The Department of Child & Adolescent Psychiatry and Behavioral Science (DCAPBS) at Children's Hospital of Philadelphia has agreements with the list of insurance plans provided in the alphabetical list on this page. Each agreement is different and benefit coverage may vary.

Please contact your Behavioral Health insurance plan to confirm the participation status for the specific CHOP provider and facility. Plans may be added or deleted and health plan acceptance may vary by provider.

Please note the following:

• Some facilities or types of services may result in two separate bills — a Hospital bill and a Physician bill. Generally, professional services provided in certain types of facilities (e.g., a hospital or an ambulatory surgical center) are not included in the facility’s charges.
• In some cases, professionals who offer services in a facility may or may not participate with the same health benefits as the facility. For additional information about the professional’s participation status, you may contact our Pre-Visit Financial Counseling Hotline at 267-426-1467 or the CHOP provider’s office.
• For further consultation on costs, contact your insurance carrier, your provider, or the CHOP Patient Cost Estimate Department at patientcostestimates@email.chop.edu or 267-426-1467

Some plans that cover behavioral health services only cover those services that are linked to a specific medical diagnosis. These types of plans are specified below. Other plans cover services based solely on a mental health diagnosis. Possible scenarios described below: :

• Plans that cover a medical diagnosis. A medical diagnosis requiring care from a mental health professional is one where there is either: (a) an emotional or behavioral response to a medical diagnosis that interferes with the child's medical care, or (b) a behavioral problem that led to the medical problem.
  • Example: A child is diagnosed with cancer and must have chemotherapy. But a fear of needles keeps him from his treatment. This requires care from mental health professional who will help him overcome his fear.
  • Example: A child with Crohn’s disease experiences a disease flare and is hospitalized, unable to attend school, spend time with friends or participate in after school activities. The mental health professional can help the child learn ways to manage her pain, to help relieve her anxiety related to resuming her normal activities.
• Plans that cover a mental health diagnosis. A mental health diagnosis is one where the primary issue that led the family to bring their child in for care is behavioral, not physical.
  • Examples include: autism, attention deficit disorder, anxiety and depression.

Insurance plans participating with CHOP Behavioral Health

Mental Health Diagnosis

• Aetna Behavioral Health
• Allied Trades Assistance Program
• Cigna Behavioral Health
• Community Behavioral Health (CBH) – PA members at PA sites and providers only
• Community Care Behavioral Health (CCBH) – Delaware and Chester Counties
• CoreSource - Lancaster General Hospital Plan - PA members at PA sites and providers only
• ComPsych
• Highmark Blue Shield- PA member at PA sites and providers only
• Horizon Blue Cross Blue Shield New Jersey
• Independence
• Magellan Health Services, commercial plans
• Magellan Medicaid PA - PA members at PA sites and providers only
• Medical Assistance of NJ – NJ members only at programs below
  • Children’s Intensive Emotional and Behavioral Program (“the CIEBP”) located in Atlantic County
  • Outpatient Rehab and Ambulatory Surgery at Voorhees Specialty Care Center
• MH Consultants
• QualCare
• Quest Behavioral Health
• TRICARE East: Humana Military
• Optum Behavioral Health
• UPMC Behavioral Health

Medical Diagnosis

• Aetna
• AmeriHealth
• Cigna Health Plan
• Independence
• Oxford –Liberty and Freedom product line
• United Healthcare