Mercy Care Plan (AZ Medicaid)

MedicaidAZ

ABA billing requirements · Source: Mercy Care Plan Provider Resources — Behavioral Health

Medium 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

State licensure requiredBCBA state licensure required via AZ Board of Behavioral Health Examiners

Documentation Requirements

Parent signatures required Yes

Start/stop times required Yes

Treatment plan componentsASD diagnosis, Functional Behavior Assessment, Baseline data, Measurable goals, Intervention strategies

Progress summary cadenceEvery 6 months

Policy Notes

Mercy Care Plan is an AHCCCS Medicaid MCO operated by Southwest Catholic Health Network. ABA requires prior auth. Serves Maricopa, Pima, and other AZ counties. BCBA must be enrolled with AHCCCS. Behavioral health services managed through Mercy Care BH.

CPT & Modifier Rules

CPT rules require a free account

View H-codes, modifiers, unit limits, and billing restrictions for Mercy Care Plan (AZ Medicaid).

Official policy source:Mercy Care Plan Provider Resources — Behavioral Health

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

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