Delaware Medicaid

MedicaidDE

ABA billing requirements · Source: Delaware Medicaid — ABA Services Coverage

High confidence

Verified 2026-03-01

Authorization Requirements

Requires prior auth Yes

Initial auth durationN/A

Renewal auth durationN/A

Submission deadlineN/A

Unit tracking cadenceTotal

Requires FBA Yes

Diagnostic eval validityN/A

Re-eval cadenceEvery 6 months

Documentation Requirements

Parent signatures required No

Start/stop times required Yes

Treatment plan componentsmeasurable goals and expected outcomes, specific description of recommended amount, type, frequency, setting and duration of ASD treatment services, amount and type of recommended caregiver ongoing participation, person-centered and based upon individualized goals, developed by a qualified autism service provider, frequency of baseline behaviors and treatment planned, long, intermediate, and short-term goals and objectives, outcome measurement assessment criteria

Progress summary cadenceEvery 6 months

Policy Notes

Prior authorization is required for plans recommending more than 40 hours per week. Behavioral assessments should be reviewed no less frequently than every six months. Caregiver participation is encouraged but not required.

CPT & Modifier Rules

CPT rules require a free account

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

Official policy source:Delaware Medicaid — ABA Services Coverage

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

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