Buckeye Health Plan (OH Medicaid)

MedicaidOH

ABA billing requirements · Source: Buckeye Health Plan Clinical Policy CP.BH.104 — Applied Behavior Analysis Autism

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

State licensure requiredBCBA state licensure required via OH Counselor, Social Worker and Marriage & Family Therapist Board

Documentation Requirements

Parent signatures required Yes

Start/stop times required Yes

Treatment plan componentsASD diagnosis (DSM-5), Functional Behavior Assessment, Baseline data, Measurable goals, Intervention strategies, Supervision plan, Parent training component

Progress summary cadenceEvery 6 months

Policy Notes

Buckeye Health Plan is Centene's Ohio Medicaid MCO. Prior auth required for all ABA services. Initial assessment (97151) requires separate auth. Renewal requires updated treatment plan and progress data. BCBA must be enrolled with Buckeye.

CPT & Modifier Rules

CPT rules require a free account

View H-codes, modifiers, unit limits, and billing restrictions for Buckeye Health Plan (OH Medicaid).

Official policy source:Buckeye Health Plan Clinical Policy CP.BH.104 — Applied Behavior Analysis Autism

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

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