Vermont Medicaid (Green Mountain Care)

MedicaidVT

ABA billing requirements · Source: Vermont Medicaid — ABA Services Coverage

High confidence

Verified 2026-03-01

Authorization Requirements

Requires prior auth Yes

Initial auth duration6 months

Renewal auth duration6 months

Submission deadlineN/A

Unit tracking cadenceMonthly

Requires FBA Yes

Diagnostic eval validityN/A

Re-eval cadenceN/A

State licensure requiredBCBA state licensure required via VT Office of Professional Regulation

Documentation Requirements

Parent signatures required Yes

Start/stop times required Yes

Treatment plan componentsPrescription for ABA services, Current diagnostic assessment, An assessment by a BCBA, Comprehensive treatment plan, Progress notes, Discharge plan

Progress summary cadenceEvery 3 months

Policy Notes

ABA services are covered for children from birth to age 21. Two payment methods exist: Case Rate for Medicaid-only members and fee-for-service for those with other insurance. Prior authorization is valid for up to six months. A progress summary is required every 90 days.

CPT & Modifier Rules

CPT rules require a free account

View H-codes, modifiers, unit limits, and billing restrictions for Vermont Medicaid (Green Mountain Care).

Official policy source:Vermont Medicaid — ABA Services Coverage

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

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