CurrentUnitedHealthcarePolicy 2026T0314CC

Sensory Integration Therapy and Auditory Integration Training

UnitedHealthcare Commercial and Individual Exchange medical policy defining coverage stance, clinical evidence summary, and coding reference for Sensory Integration Therapy (SIT) and Auditory Integration Training (AIT). Applies to UnitedHealthcare Commercial and Individual Exchange benefit plans.

Policy Summary

PayerUnitedHealthcare

PolicySensory Integration Therapy and Auditory Integration Training

Policy CodePolicy 2026T0314CC

Change TypeTemplate Update

Effective DateJan 1, 2026

Next Review Date

Key ActionDocument and retain supporting evidence and literature citations; note policy states SIT and AIT are unproven and not medically necessary due to insufficient evidence of efficacy.

SourceLink

POLICY UPDATE CHANGES

01/01/2026, Summary of Changes = Template Update

2Treatments designated not medically necessary

1Referenced CPT code listed

multipleCited Studies/Guidance

10Document length (part indicator)

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UnitedHealthcare Commercial and Individual Exchange policy for Sensory Integration Therapy (SIT) and Auditory Integration Training (AIT). Effective date: January 1, 2026; Last review: January 1, 2026. This policy defines the coverage stance that SIT and AIT are not medically necessary / unproven and are designated as non-covered for treating any condition. Both SIT and AIT are considered investigational/unproven (SIT and AIT designated not medically necessary).

Key Policy Attributes

Policy Number2026T0314CC

PayerUnitedHealthcare

Policy TypeMedical Policy

Effective DateJanuary 1, 2026

Last ReviewJanuary 1, 2026

Scope SummaryUnitedHealthcare Commercial and Individual Exchange medical policy defining coverage stance, clinical evidence summary, and coding reference for Sensory Integration Therapy (SIT) and Auditory Integration Training (AIT). Applies to UnitedHealthcare Commercial and Individual Exchange benefit plans.

Medical Necessity / Coverage Rationale

Coverage Rationale - SIT and AIT

The following are unproven and not medically necessary for treating any condition due to insufficient evidence of efficacy:

ALL of the following

Sensory integration therapy (SIT) is considered unproven and not medically necessary for treating any condition.
Auditory integration training (AIT) is considered unproven and not medically necessary for treating any condition.

Not Medically Necessary / Investigational

Policy stance: Sensory integration therapy (SIT) and Auditory integration training (AIT) are unproven and not medically necessary for treating any condition due to insufficient evidence of efficacy. Use this determination for coverage and billing decisions; refer to the member-specific benefit plan document for final benefit determination.

Provider Actions and Documentation

Documentation Required

Reference and Evidence Documentation

Retain documented evidence and literature citations used to support clinical decisions. The policy states SIT and AIT are unproven and not medically necessary due to insufficient evidence of efficacy, so maintain records of the clinical rationale and references when submitting or appealing coverage determinations.

97533

Documentation Required

Reference member-specific benefit plan

Coverage decisions are governed by the member-specific benefit plan document; when the terms of the member-specific document differ from this Medical Policy, the member-specific document controls. Providers should consult the member-specific benefit plan for final determination of coverage.

Documentation Required

Check applicable mandates and Medicare guidance

Verify applicable federal and state mandates and Medicare guidance before applying this policy. In the absence of a Medicare National Coverage Determination (NCD) or Local Coverage Determination (LCD), Medicare Advantage Organizations may establish their own coverage determinations per CMS guidance; note that this policy's medicare_determinations list is empty.

Documentation Required

Use of third-party criteria permitted

UnitedHealthcare may use third-party tools (for example, InterQual) to assist in administering benefits. Providers should be aware that coverage determinations may rely in part on such third-party criteria.

Background and Evidence Summary

Background: SIT seeks to improve perception and integration of sensory information to help individuals with learning disabilities or autism spectrum disorder and is typically delivered by occupational therapists using vestibular, proprioceptive, and tactile stimulation (e.g., textured mitts, swings, weighted vests) in individual sessions. AIT (e.g., Berard or TOMATIS® protocols) involves listening to modulated/filtered music via headphones across multiple sessions to address abnormal sound sensitivity.

Study / Source	Summary
Systematic review (Acuña et al., 2025)
Found strong evidence from five RCTs that Ayres Sensory Integration (ASI) supports autistic children in meeting individualized goals, but noted study heterogeneity and bias concerns; further research needed.
Large RCT (Randell et al., 2022)
SenITA RCT (n=138) found no statistically significant effects of SIT on primary outcome or most secondary outcomes compared to usual care; no meaningful improvements at 6 and 12 months.
Population cohort (Tzang et al., 2019)
Nationwide propensity-score matched cohort in children with ADHD found sensory integration associated with increased incidence of psychiatric disorders (adjusted HR 1.41); observational design limits causal inference.
AIT evidence summary / TOMATIS studies (Fu et al., 2024; El-Tellawy et al., 2022)
Small RCTs and uncontrolled studies of TOMATIS/TOMATIS® show inconsistent or limited positive findings; studies have methodological limitations and uncertain generalizability.
AHRQ / Weitlauf et al. (2017) and other systematic reviews
Comparative reviews concluded sensory-based/SI interventions show low-strength evidence for some sensory and motor improvements; auditory-integration approaches did not improve language outcomes (low SOE); studies small and heterogeneous.
Limited literature and professional society positions (AAA 2010; ASHA 2004; NICE CG170)
Professional organizations consider AIT investigational or not recommended; NICE states AIT should not be used to manage speech and language problems in children and young people with autism.

Definitions:

Sensory Integration Therapy (SIT): Therapy that seeks to improve perception and integration of sensory information using techniques such as textured mitts, swings, scooter boards, ramps, bounce pads, suspended equipment, and weighted vests or blankets; typically provided by occupational therapists in 60–90 minute individual sessions and delivered over weeks to months.

Auditory Integration Training (AIT): Techniques (e.g., Berard, TOMATIS®) that require listening to modulated or filtered music via headphones over multiple sessions (for example, Berard AIT: 10 hours over 10–12 days) intended to improve abnormal sound sensitivity.

Policy Summary

PayerUnitedHealthcare

PolicySensory Integration Therapy and Auditory Integration Training

Policy CodePolicy 2026T0314CC

Change TypeTemplate Update

Effective DateJan 1, 2026

Next Review Date

Key ActionDocument and retain supporting evidence and literature citations; note policy states SIT and AIT are unproven and not medically necessary due to insufficient evidence of efficacy.

SourceLink

On This Page

OpenPayer

Sensory Integration Therapy and Auditory Integration Training

Coverage Summary

Medical Necessity / Coverage Rationale

Not Medically Necessary / Investigational

Coding Reference

Provider Actions and Documentation

Background and Evidence Summary

Revision History