Florida KidCare (CHIP)

GovernmentFL

ABA billing requirements · Source: Florida KidCare — Provider Resources (Behavioral Health)

High confidence

Verified 2026-03-16

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

BH carve-out managerCarelon

State licensure requiredBCBA state certification required via FL Agency for Health Care Administration

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 plan

Progress summary cadenceEvery 6 months

Policy Notes

Florida KidCare is the CHIP program for children not eligible for Medicaid, administered through MediKids (AHCA), Florida Healthy Kids (FHK), and Medicaid for children. ABA prior auth required. Behavioral health managed through Sunshine Health or Simply Healthcare depending on plan. BCBA must be enrolled with the specific KidCare plan.

CPT & Modifier Rules

CPT rules require a free account

View H-codes, modifiers, unit limits, and billing restrictions for Florida KidCare (CHIP).

Official policy source:Florida KidCare — Provider Resources (Behavioral Health)

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Data last verified: 2026-03-16 · Confidence: High · See our methodology

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