BCBS Massachusetts

CommercialMA

ABA billing requirements · Source: BCBS Massachusetts Provider Manual — ABA Services

High confidence

Verified 2026-03-01

Authorization Requirements

Requires prior auth Yes

Initial auth duration6 months

Renewal auth duration6 months

Submission deadline30 days

Unit tracking cadenceTotal

Requires FBA Yes

Diagnostic eval validity36 months

Re-eval cadenceEvery 12 months

State licensure requiredLABA (MA Board of Registration of Allied Mental Health Professionals)

Parent signatures required Yes

Start/stop times required Yes

Treatment plan componentsDiagnosis, Baseline, Goals, Methods, Supervision ratio

Progress summary cadenceEvery 6 months

State autism mandate requires coverage. No annual dollar cap. BCBA supervision required. Distinct from national Anthem policy.

CPT rules require a free account

View H-codes, modifiers, unit limits, and billing restrictions for BCBS Massachusetts.

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