Wellmark BCBS

CommercialIA/SD

ABA billing requirements · Source: Wellmark BCBS — ABA Prior Approval Policy (FEP)

Medium confidence

Verified 2026-03-01

Authorization Requirements

Requires prior auth Yes

Initial auth durationN/A

Renewal auth durationN/A

Submission deadlineN/A

Unit tracking cadenceWeekly

Requires FBA Yes

Diagnostic eval validityN/A

Re-eval cadenceEvery 3 months

Documentation Requirements

Parent signatures required Yes

Start/stop times required Yes

Treatment plan componentsIndividualized treatment plan, Progress report documents

Progress summary cadenceEvery 3 months

Policy Notes

ABA Services are subject to prior approval, however, prior approval does not guarantee coverage. This document is a pre-service inquiry form for Federal Employee Program (FEP) members.

CPT & Modifier Rules

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View H-codes, modifiers, unit limits, and billing restrictions for Wellmark BCBS.

Official policy source:Wellmark BCBS — ABA Prior Approval Policy (FEP)

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

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