California Restores Commercial Coverage for Telehealth ABA by Paraprofessionals

Governor Newsom signed AB 375 on September 27 as Chapter 501, Statutes of 2026. It adds “a qualified autism service paraprofessional as defined in Section 4999.202” to the definition of “health care provider” in Business and Professions Code §2290.5, the state's telehealth statute. It takes effect January 1, 2027.

The turn: one word in a definition, and the coverage follows

AB 375 doesn't mention coverage. Its effect runs through the telehealth parity law. Health and Safety Code §1374.14 requires plans to cover services “appropriately delivered through telehealth services on the same basis and to the same extent” as in-person care, delivered by a “health care provider.” Qualified autism service providers and professionals were already in that definition. Paraprofessionals, the line staff who deliver most direct treatment, weren't.

The Senate floor analysis says plans covered paraprofessional telehealth under a COVID-19 executive order. Once the order ended, that coverage stopped. Its summary of the bill: “requiring health insurers and health plans to cover behavioral health treatment provided by QASPPs via telehealth.”

The Autism Business Association sponsored the bill. No opposition was recorded, and it passed without a no vote.

What comes with it

Under §2290.5(b), the provider starting telehealth must tell the patient and get “verbal or written consent,” and “the consent shall be documented.” From January 1 that duty extends to paraprofessionals. The bill's digest notes that expanding the definition also expands the scope of a crime under the Medical Practice Act.

The limits

• Parity means “the same basis” as in person. Plans can still apply medical necessity and treatment-plan requirements.
• The analysis is about commercial plans and insurers. It doesn't address Medi-Cal, and self-funded employer plans aren't reached by state mandates.
• Appropriations staff flagged possible costs of “hundreds of thousands to low millions of dollars” for regional centers. How that plays out isn't settled.

What you must know or do

• Billers: pull commercial denials for telehealth 97153 delivered by paraprofessionals since the COVID order ended. Those plans are the ones to re-query after January 1.
• Clinical directors: decide which clients' treatment plans support telehealth direct treatment. Parity doesn't make telehealth appropriate for every goal.
• Operations: add a telehealth consent step, documented in the record, to any session a paraprofessional will run remotely from January 1.