CareSource

CommercialGA/OH

ABA billing requirements · Source: CareSource Commercial — ABA Medical Policy

High confidence

Verified 2026-03-01

Authorization Requirements

Requires prior auth Yes

Initial auth duration6 months

Renewal auth duration6 months

Submission deadlineN/A

Unit tracking cadenceTotal

Requires FBA Yes

Diagnostic eval validity36 months

Re-eval cadenceEvery 36 months

Documentation Requirements

Parent signatures required Yes

Start/stop times required Yes

Treatment plan componentsdevelopmentally appropriate and specific goals, objective and measurable goals, projected timeline for goal attainment, specific interventions and supports, plan for generalization and maintenance of skills, plan for caregiver/family training, discharge plan, dated signature of the member or parent/guardian, dated signature of the provider

Progress summary cadenceEvery 6 months

Policy Notes

The policy applies to both GA and OH Marketplace plans. Initial and renewal authorizations are for up to 6 months. A diagnostic evaluation is valid for 3 years, and a re-evaluation is required every 3 years.

CPT & Modifier Rules

CPT rules require a free account

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

Official policy source:CareSource Commercial — ABA Medical Policy

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

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