Massachusetts Medicaid (MassHealth)

MedicaidMA

ABA billing requirements · Source: MassHealth — ABA Services Coverage Policy

Low 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 cadenceN/A

State licensure requiredLABA (MA Board of Registration of Allied Mental Health Professionals)

Documentation Requirements

Parent signatures required Yes

Start/stop times required Yes

Treatment plan componentsIndividualized care plans

Progress summary cadenceEvery 6 months

Policy Notes

This report is an audit of MassHealth's ABA program, not a policy document. It mentions that MCEs require ABA providers to have policies for prior authorization and that LABAs provide 1 hour of supervision for every 10 hours of direct ABA services. It also mentions that treatment plans are highly individualized.

CPT & Modifier Rules

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

Official policy source:MassHealth — ABA Services Coverage Policy

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

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