Carolina Complete Health (NC Medicaid)

MedicaidNC

ABA billing requirements · Source: Carolina Complete Health — Provider Resources

Medium 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 NC Psychology 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

Progress summary cadenceEvery 6 months

Policy Notes

Carolina Complete Health (Centene) is a NC Standard Plan Medicaid MCO. ABA requires prior auth. Behavioral health managed internally. BCBA must be enrolled with NC Medicaid and Carolina Complete Health.

CPT & Modifier Rules

CPT rules require a free account

View H-codes, modifiers, unit limits, and billing restrictions for Carolina Complete Health (NC Medicaid).

Official policy source:Carolina Complete Health — Provider Resources

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

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