Utah Medicaid

MedicaidUT

ABA billing requirements · Source: Utah Medicaid — ABA Services Coverage Policy

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 componentsDate of assessment(s), Name and signature of QHP, Assessment tool(s), Summary of assessment results, Baseline data, Summary data from parent/caregiver, Identification and description of targeted skills, Identification and description of targeted maladaptive behaviors, Measurable treatment goals, Method and frequency of implementing and assessing treatment protocols, Anticipated caregiver involvement, Anticipated coordination of care needs

Progress summary cadenceEvery 6 months

Policy Notes

ABA services are covered for all eligible Medicaid members with a diagnosis of ASD, regardless of age. ABA behavior technicians must be fully certified prior to performing services. Prior authorization is required for ABA services, but not for initial or ongoing behavior identification assessments. Assessments are generally performed on the initiation of services and every six months thereafter. The assessment's total time or start and stop times should be noted in the medical record.

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Official policy source:Utah Medicaid — ABA Services Coverage Policy

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

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