Superior Health Plan (TX Medicaid)

MedicaidTX

ABA billing requirements · Source: Superior Health Plan — ABA Services Prior Authorization (Magellan carve-out)

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

BH carve-out managerMagellan

State licensure requiredLBAS (TX State Board of Examiners of Psychologists) — required for Medicaid billing

Documentation Requirements

Parent signatures required Yes

Start/stop times required Yes

Treatment plan componentsASD diagnosis, Functional Behavior Assessment, Baseline data, Measurable goals, Intervention strategies, Parent training plan, Discharge criteria

Progress summary cadenceEvery 6 months

Policy Notes

Superior Health Plan (Centene) is one of the largest Texas STAR/CHIP Medicaid MCOs. ABA services require prior auth through Magellan Healthcare (behavioral health carve-out). Providers must be enrolled in both Superior and Magellan networks. Auth requests to Magellan at 1-888-656-0368.

CPT & Modifier Rules

CPT rules require a free account

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

Official policy source:Superior Health Plan — ABA Services Prior Authorization (Magellan carve-out)

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

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