Oklahoma Medicaid (SoonerCare)

MedicaidOK

ABA billing requirements · Source: Oklahoma SoonerCare — ABA Services Policy

High 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

Documentation Requirements

Parent signatures required Yes

Start/stop times required Yes

Treatment plan componentsPerson-centered and individualized, Baseline levels of target behaviors, Long-term and short-term objectives, Criteria for achievement of objectives, Functional goals related to core deficits of ASD, Specific functional goals with time frame, Operational behavior definition, Prevention and intervention strategies, Schedules of reinforcement, Functional alternative responses, Goals matching setting, Titration plan to fade services, Schedule of services, Individuals responsible for delivering services, Frequent review of data, Adjustments in treatment plan/protocols, Training and supervision for BCaBAs and RBTs, Date of training, Techniques utilized, Supports used to enable parents and caregivers, Care coordination, Consistency with professional standards and guidelines, Clinical assessment, FBA (Operational definition of problematic behavior, History of problematic behavior, Antecedent analysis, Consequence analysis, Impression and analysis of function of problematic behavior)

Progress summary cadenceEvery 6 months

Policy Notes

Policy revised on 2025-09-01. Prior authorization is required. Functional Behavior Assessment (FBA) is required. Parent/legal guardian signatures are required on treatment plans. Start and stop times must be documented for each session.

CPT & Modifier Rules

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

Official policy source:Oklahoma SoonerCare — ABA Services Policy

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

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