Aetna Better Health (Medicaid)

Medicaid

ABA billing requirements · Source: Aetna Better Health — Provider Resources (Medicaid)

High confidence

Verified 2026-03-01

Authorization Requirements

Requires prior auth Yes

Initial auth duration6 months

Renewal auth duration6 months

Submission deadline14 days

Unit tracking cadenceTotal

Requires FBA Yes

Diagnostic eval validity36 months

Re-eval cadenceEvery 6 months

BH carve-out managerMagellan

Documentation Requirements

Parent signatures required Yes

Start/stop times required Yes

Treatment plan componentsASD diagnosis, Functional Behavior Assessment, Baseline data, Measurable goals, Intervention strategies, Caregiver training plan

Progress summary cadenceEvery 6 months

Policy Notes

Aetna Better Health is CVS/Aetna's Medicaid MCO brand operating in VA, WV, OK, PA, NJ, IL, KY, and other states. ABA prior auth required. Behavioral health managed internally. BCBA must be enrolled with Aetna Better Health in the specific state. Distinct from commercial Aetna.

CPT & Modifier Rules

CPT rules require a free account

View H-codes, modifiers, unit limits, and billing restrictions for Aetna Better Health (Medicaid).

Official policy source:Aetna Better Health — Provider Resources (Medicaid)

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Data last verified: 2026-03-01 · Confidence: High · See our methodology

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