Humana Healthy Horizons (Medicaid)

Medicaid

ABA billing requirements · Source: Humana Healthy Horizons — Provider Resources (Medicaid)

High 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

Documentation Requirements

Parent signatures required Yes

Start/stop times required Yes

Treatment plan componentsASD diagnosis, Functional Behavior Assessment, Baseline data, Goals, Methods, Parent training, Discharge criteria

Progress summary cadenceEvery 6 months

Policy Notes

Humana Healthy Horizons is Humana's Medicaid MCO brand operating in FL, IL, IN, KY, OH, OK, SC, TX, and other states. ABA prior auth required. Behavioral health managed internally. BCBA must be enrolled with Humana Healthy Horizons in the specific state. Distinct from commercial Humana.

CPT & Modifier Rules

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View H-codes, modifiers, unit limits, and billing restrictions for Humana Healthy Horizons (Medicaid).

Official policy source:Humana Healthy Horizons — Provider Resources (Medicaid)

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

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