Meridian Health Plan (IL/MI Medicaid)

MedicaidIL

ABA billing requirements · Source: Meridian Health Plan — Provider Resources

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 IL Department of Financial and Professional Regulation

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

Meridian Health Plan (WellCare/Centene) operates in Illinois and Michigan Medicaid. ABA prior auth required. Behavioral health managed internally. BCBA must be enrolled with Meridian. In IL, Meridian is a major Medicaid MCO under the Managed Care Reform and Patient Rights Act.

CPT & Modifier Rules

CPT rules require a free account

View H-codes, modifiers, unit limits, and billing restrictions for Meridian Health Plan (IL/MI Medicaid).

Official policy source:Meridian Health Plan — Provider Resources

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

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