Sunflower Health Plan (KS Medicaid)

MedicaidKS

ABA billing requirements · Source: Sunflower Health Plan Clinical Policy KS.CP.01 — Applied Behavioral Analysis

High 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 KS Behavioral Sciences Regulatory Board

Documentation Requirements

Parent signatures required Yes

Start/stop times required Yes

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

Progress summary cadenceEvery 6 months

Policy Notes

Sunflower Health Plan is the primary Medicaid MCO in Kansas (KanCare). ABA requires prior auth. Behavioral health services are carved into Sunflower. BCBA must hold Kansas licensure. Auth requests submitted via Availity or fax.

CPT & Modifier Rules

CPT rules require a free account

View H-codes, modifiers, unit limits, and billing restrictions for Sunflower Health Plan (KS Medicaid).

Official policy source:Sunflower Health Plan Clinical Policy KS.CP.01 — Applied Behavioral Analysis

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

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