DC Medicaid

MedicaidDC

ABA billing requirements · Source: DC Medicaid — ABA Services Coverage 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 validityN/A

Re-eval cadenceEvery 6 months

Documentation Requirements

Parent signatures required Yes

Start/stop times required Yes

Treatment plan componentsLong, intermediate, and short-term goals, Specific service type with recommended amount, frequency, setting and duration, Outcome measurement assessment criteria, Consistency with evidence-based ASD interventions, Frequency of progress reporting and responsible providers

Progress summary cadenceEvery 6 months

Policy Notes

ASD services are for children and adolescents under age 21. Treatment plans are reviewed every six months and require prior approval. ABA therapy is a type of ASD treatment service.

CPT & Modifier Rules

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

Official policy source:DC Medicaid — ABA Services Coverage Policy

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

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