Indiana Medicaid (FSSA)

MedicaidIN

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

High confidence

Verified 2026-03-01

1 active policy alert

Indiana proposes 30-hour weekly cap and 3-year lifetime limit for comprehensive ABAEffective 2026-07-01

Indiana HB 1103 proposes a 30-hour/week cap on comprehensive ABA services and a 3-year lifetime maximum for comprehensive ABA. Practices would be required to transition clients to 'focused ABA' unless medical necessity for comprehensive services is clearly documented. The bill also mandates Medicaid credentialing for all RBTs.

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 cadenceN/A

State licensure requiredBCBA state licensure required via IN Professional Licensing Agency

Documentation Requirements

Parent signatures required Yes

Start/stop times required Yes

Treatment plan componentsBehaviors to be targeted, Psychological concerns, Medical concerns, Family issues affecting patient or affected by patient condition, Hours spent in school (includes home school), Current therapies such as OT, PT, Speech that are occurring separate from ABA, Location of service, Has a baseline measurement been performed and documented for this goal?, Has a timeline been established for ameliorating this behavior in a measurable way?, Are goals/interventions modified if there is lack of progress?, Has the provider performing therapy been identified? (RBT, BCBA, HSPP, etc.), Have the hours requested for each goal been substantiated?

Progress summary cadenceEvery 6 months

Policy Notes

This document is a prior authorization checklist for ABA services. It outlines requirements for diagnostic assessment and treatment plan components. It also mentions parental training requirements.

CPT & Modifier Rules

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

Official policy source:Indiana Medicaid — ABA Services Coverage

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

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