Rhode Island Medicaid

MedicaidRI

ABA billing requirements · Source: Rhode Island Medicaid — ABA Services Coverage

High confidence

Verified 2026-03-01

Authorization Requirements

Requires prior auth Yes

Initial auth duration12 months

Renewal auth durationN/A

Submission deadlineN/A

Unit tracking cadenceTotal

Requires FBA Yes

Diagnostic eval validity36 months

Re-eval cadenceEvery 36 months

State licensure requiredBCBA state licensure required via RI Department of Health

Documentation Requirements

Parent signatures required Yes

Start/stop times required Yes

Treatment plan componentsInitial assessment, Client assets and needs, Client goals care/Treatment Plan, Documentation of care/services provided, Documentation of change in client’s status, Discharge summary, Curriculum scope and sequence, Skills assessment, Teaching techniques, Reinforcement techniques, Measurement of effectiveness, Functional assessment/analysis

Progress summary cadenceEvery 6 months

Policy Notes

HBTS Treatment Plans are approved for 12 months with required 6 month progress reports. A formal Behavioral Health or Medical diagnosis must be made within 3 years by a qualified licensed health care professional. Additional evaluations must take place within three years following the beginning of home-based treatment, or as needed. Prior authorization is required for Home Based – Specialized Treatment and Home Based – Treatment Support.

CPT & Modifier Rules

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View H-codes, modifiers, unit limits, and billing restrictions for Rhode Island Medicaid.

Official policy source:Rhode Island Medicaid — ABA Services Coverage

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

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