Oregon Health Plan

MedicaidOR

ABA billing requirements · Source: Oregon Health Plan — OAR 410-172-0760 ABA Services

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 cadenceEvery 6 months

Documentation Requirements

Parent signatures required Yes

Start/stop times required Yes

Treatment plan componentsspecific, observable, and quantifiable goals

Progress summary cadenceEvery 6 months

Policy Notes

ABA services are covered for autism spectrum disorder and stereotyped movement disorder with self-injurious behavior. Initial and ongoing assessments are required every six months.

CPT & Modifier Rules

CPT rules require a free account

View H-codes, modifiers, unit limits, and billing restrictions for Oregon Health Plan.

Official policy source:Oregon Health Plan — OAR 410-172-0760 ABA Services

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

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