California Medicaid (Medi-Cal)

MedicaidCA

ABA billing requirements · Source: California DHCS — Applied Behavior Analysis Services

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

State licensure requiredBCBA state registration required via CA Board of Behavioral Sciences

Documentation Requirements

Parent signatures required Yes

Start/stop times required Yes

Treatment plan componentsDiagnosis, Baseline, Goals, Methods, Progress measures

Progress summary cadenceEvery 12 months

Policy Notes

Medi-Cal covers ABA under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit. No age cap for Medi-Cal. Annual auth periods. Managed through regional Medi-Cal plans.

CPT & Modifier Rules

CPT rules require a free account

View H-codes, modifiers, unit limits, and billing restrictions for California Medicaid (Medi-Cal).

Official policy source:California DHCS — Applied Behavior Analysis Services

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

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