Trillium Health Resources (NC LME-MCO)

MedicaidNC

ABA billing requirements · Source: Trillium Health Resources — Medicaid Child BH Benefit Plan

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 NC Psychology 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, Family training plan

Progress summary cadenceEvery 6 months

Policy Notes

Trillium Health Resources is the LME-MCO for eastern NC (Onslow, Carteret, and surrounding counties). ABA prior auth required. BCBA must be credentialed with Trillium.

CPT & Modifier Rules

CPT rules require a free account

View H-codes, modifiers, unit limits, and billing restrictions for Trillium Health Resources (NC LME-MCO).

Official policy source:Trillium Health Resources — Medicaid Child BH Benefit Plan

Track policy changes for Trillium Health Resources (NC LME-MCO)

Get instant alerts when Trillium Health Resources (NC LME-MCO) updates their ABA billing requirements. Watch this payor and never miss a policy change.

Watch this payor — free Browse all 192 payors

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

Inaccurate data? Sign in to submit a correction