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DSM-5 Diagnostic Checklist

TRICARE requires a completed DSM-5 Diagnostic Checklist for all beneficiaries in the Autism Care Demonstration (ACD). For beneficiaries new to the ACD as of Oct. 1, 2021, the checklist is required prior to enrollment and at each two-year referral renewal. For beneficiaries enrolled prior to Oct. 1, 2021, the checklist is required at their next referral cycle and each two-year referral renewal. The DSM-5 Diagnostic Checklist identifies the level of support required according to DSM-5 autism spectrum disorder (ASD) criteria. This form must be completed by TRICARE-authorized, ASD-diagnosing or referring providers only. Applied behavior analysis (ABA) providers are not permitted to complete this checklist.

  • Created: Nov 3, 2021
  • Modified: Nov 3, 2021
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