AOTA advocacy leads to BCBS Michigan coverage of Ayres Sensory Integration® for autism

The American Occupational Therapy Association (AOTA) is pleased to announce a significant advocacy win for occupational therapy practitioners (OTPs), clients, and their families in Michigan. Following outreach and engagement by AOTA, Blue Cross Blue Shield of Michigan (BCBSM) will begin covering Ayres Sensory Integration® (ASI) for individuals with an autism diagnosis, effective March 1, 2026.

This important policy change expands access to evidence-based occupational therapy (OT) services and reflects the growing recognition of sensory integration's role in supporting meaningful participation and functional progress.

Addressing a gap in coverage

In 2025, AOTA received concerns from members in Michigan regarding BCBSM’s policy language, which excluded coverage of sensory integration interventions under CPT® code 97533. In response, AOTA’s Regulatory Affairs submitted a letter to BCBS Michigan leadership requesting a review of the payer’s sensory integration policy with supporting information, including:

• The evidence base supporting Ayres Sensory Integration® interventions
• The role of sensory integration interventions within a client-centered, occupation-focused plan of care
• The importance of ensuring equitable access to medically necessary OT services for individuals with autism

This led to a meeting with BCBS Michigan’s medical policy review committee in December 2025. 

The role of evidence in achieving policy change

Supporting evidence played a central role in AOTA’s advocacy efforts with BCBS Michigan. During the December meeting, AOTA highlighted the growing body of peer-reviewed research demonstrating that Ayres Sensory Integration techniques, when delivered by OTPs, can lead to measurable improvements in sensory processing, functional participation, adaptive behavior, and goal attainment for individuals with autism. By presenting clear, methodologically sound studies and emphasizing ASI’s structured, validated intervention framework, AOTA illustrated not only clinical effectiveness but also alignment with best practices and standards of care. This evidence-driven approach was instrumental in helping BCBS Michigan update its policy language and recognize ASI as a medically appropriate intervention reimbursable under CPT code 97533.

A successful advocacy outcome

This revision ensures that:

• OTPs providing ASI interventions can be reimbursed appropriately
• Clients and families can access needed sensory integration treatment without undue financial burden
• OT services are aligned with current clinical standards and best practices

AOTA appreciates BCBS Michigan’s willingness to engage in constructive dialogue and to update policies in ways that reflect both evidence and the needs of beneficiaries.

AOTA’s ongoing commitment to advocacy

This advocacy win reflects AOTA’s broader commitment to advancing reimbursement policies that recognize the full scope of occupational therapy practice. By advocating directly with insurers, regulators, and policymakers, AOTA works to ensure that OT services remain accessible, evidence-based, and client-centered.

This advocacy effort also demonstrates that member engagement is essential to identifying policy challenges and driving positive change.

For questions about this update or other reimbursement issues, please contact AOTA’s Regulatory Affairs team at regulatory@aota.org.