Dear SFHP Members: Congress was unable to reach an agreement on funding for Fiscal Year 2026, and the federal government was shut down on October 1, 2025. While we do not know how long the shutdown will last, SFHP will continue its operations as normal. You can still access the care you need. We are committed to ensuring your access to care is not interrupted. If you encounter any issues, please contact SFHP Customer Service at 1(415) 547 7800 or toll-free 1(800) 288 5555 (TTY users can dial 711). We’re open Monday through Friday, from 8:00am to 5:00pm.

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Autism Services

Behavioral Health Treatment (BHT) for Autism Spectrum Disorder (ASD)

This treatment includes applied behavior analysis and other evidence-based services this means the services have been reviewed and have been shown to work. The services should develop or restore, as much as possible, the daily functioning of a Member with ASD.

BHT services must be medically necessary and prescribed by a licensed doctor or a licensed psychologist. The services must be approved by SFHP and given in a way that follows the Member’s Plan-approved treatment plan.

You may qualify for BHT services if:

  • You are under 21 years of age; and
  • Have a diagnosis of ASD; and
  • Have behaviors that interfere with home or community life (some examples include anger, violence, self-injury, running away, or difficulty with living skills, play and/or communication skills).

You do not qualify for BHT services if you:

  • Are not medically stable; or
  • Need 24-hour medical or nursing services; or
  • Have an intellectual disability (ICF/ID) and need procedures done in a hospital or an intermediate care facility.

If you have any questions regarding Mental Health Services and specific Autism services please contact Carelon Behavioral Health. If you need help or have questions, call SFHP Customer Service at 1(415) 547-78001(800) 288-5555 (toll-free), or 711 (TTY), Monday–Friday, 8:30am–5:30pm.

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