Virginia Medicaid (DMAS)

MedicaidVA

ABA billing requirements · Source: Virginia DMAS — Applied Behavior Analysis Provider Manual

High confidence

Verified 2026-03-01

Authorization Requirements

Requires prior auth Yes

Initial auth duration6 months

Renewal auth duration6 months

Submission deadline30 days

Unit tracking cadenceTotal

Requires FBA Yes

Diagnostic eval validity24 months

Re-eval cadenceEvery 6 months

State licensure requiredBCBA state licensure required via VA Department of Health Professions

Documentation Requirements

Parent signatures required Yes

Start/stop times required Yes

Treatment plan componentsDiagnosis, FBA, Baseline, Goals, Methods, Caregiver training

Progress summary cadenceEvery 6 months

Policy Notes

Updated policy effective December 2025. MCOs: Aetna Better Health, Anthem HealthKeepers Plus, Magellan. Each MCO manages its own auth process under DMAS guidelines.

CPT & Modifier Rules

CPT rules require a free account

View H-codes, modifiers, unit limits, and billing restrictions for Virginia Medicaid (DMAS).

Official policy source:Virginia DMAS — Applied Behavior Analysis Provider Manual

Track policy changes for Virginia Medicaid (DMAS)

Get instant alerts when Virginia Medicaid (DMAS) 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