Blue Cross Blue Shield of Kansas

CommercialKS

ABA billing requirements · Source: Blue Cross Blue Shield of Kansas — Medical Policy: Applied Behavior Analysis

High confidence

Verified 2026-03-17

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 managerCarelon

State licensure requiredBCBA state licensure required via KS Behavioral Sciences Regulatory Board

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

Blue Cross Blue Shield of Kansas is an independent BCBS licensee covering ~900K members in Kansas (excluding Johnson and Wyandotte counties, which are served by BCBS KC). ABA prior auth required. Behavioral health managed through Carelon. BCBA must be enrolled with BCBS KS. Note: Sunflower Health Plan (Centene Medicaid) is a separate entity — BCBS KS is the commercial plan.

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View H-codes, modifiers, unit limits, and billing restrictions for Blue Cross Blue Shield of Kansas.

Official policy source:Blue Cross Blue Shield of Kansas — Medical Policy: Applied Behavior Analysis

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Data last verified: 2026-03-17 · Confidence: High · See our methodology

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