WellSense Health Plan (MA/NH Medicaid)

MedicaidMA

ABA billing requirements · Source: WellSense Health Plan — Provider Resources (Behavioral Health)

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 requiredLABA (MA Board of Registration of Allied Mental Health Professionals)

Documentation Requirements

Parent signatures required Yes

Start/stop times required Yes

Treatment plan componentsASD diagnosis, Functional Behavior Assessment, Baseline data, Measurable goals, Intervention strategies, Parent training plan

Progress summary cadenceEvery 6 months

Policy Notes

WellSense Health Plan (formerly BCBS MA Medicaid) is the MassHealth MCO and NH Medicaid MCO operated by Blue Cross Blue Shield of Massachusetts. ABA prior auth required. Behavioral health managed through Massachusetts Behavioral Health Partnership (MBHP). BCBA must be enrolled with WellSense and MBHP.

CPT & Modifier Rules

CPT rules require a free account

View H-codes, modifiers, unit limits, and billing restrictions for WellSense Health Plan (MA/NH Medicaid).

Official policy source:WellSense Health Plan — Provider Resources (Behavioral Health)

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

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