Blue Cross Blue Shield Federal Employee Program (FEP)

Commercial

ABA billing requirements · Source: BCBS Federal Employee Program — Benefit Plan Brochure (ABA coverage)

High confidence

Verified 2026-03-01

Authorization Requirements

Requires prior auth Yes

Initial auth duration12 months

Renewal auth duration12 months

Submission deadline30 days

Unit tracking cadenceTotal

Requires FBA Yes

Diagnostic eval validity36 months

Re-eval cadenceEvery 12 months

Documentation Requirements

Parent signatures required Yes

Start/stop times required Yes

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

Progress summary cadenceEvery 12 months

Policy Notes

BCBS FEP is the largest FEHB plan (~5M federal employees/retirees). ABA covered under mental health parity. Prior auth required. Behavioral health managed through Carelon (Beacon). Annual auth cycle. BCBA must be enrolled with local BCBS plan. Standard Option and Basic Option have different cost-sharing.

CPT & Modifier Rules

CPT rules require a free account

View H-codes, modifiers, unit limits, and billing restrictions for Blue Cross Blue Shield Federal Employee Program (FEP).

Official policy source:BCBS Federal Employee Program — Benefit Plan Brochure (ABA coverage)

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

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