Florida Medicaid (AHCA)

MedicaidFL

ABA billing requirements · Source: Florida AHCA — Behavior Analysis Services Coverage Policy

High confidence

Verified 2026-03-01

Authorization Requirements

Requires prior auth Yes

Initial auth duration6 months

Renewal auth duration6 months

Submission deadline30 days

Unit tracking cadenceTotal

Requires FBA Yes

Diagnostic eval validity24 months

Re-eval cadenceEvery 6 months

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 componentsDiagnosis, FBA, Baseline data, Target behaviors, Measurable goals, Discharge criteria

Progress summary cadenceEvery 6 months

Policy Notes

Transitioned to Statewide Medicaid Managed Care (SMMC) in early 2025. MCOs: Aetna Better Health, Molina, Sunshine Health, Simply Healthcare. Each MCO has its own auth portal.

CPT & Modifier Rules

CPT rules require a free account

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

Official policy source:Florida AHCA — Behavior Analysis Services Coverage Policy

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

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