Public Database

ABA Payor Authorization Requirements

Browse prior authorization rules, documentation requirements, and policy notes for 192 ABA insurance payors — free, no login required. Updated monthly for high-priority payors.

192Total payors

72Commercial

114Medicaid

6Government

156Verified data

All 192 payors

32 Health Plan (formerly Tufts Health Commercial)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-17

Absolute Total Care (SC Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

CommercialNational

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Aetna Better Health (Medicaid)

MedicaidNational

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Aetna Medicare Advantage

CommercialNational

Prior auth required12mo initial authFBA required

VerifiedVerified 2026-03-16

Alabama Medicaid

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Alaska Medicaid

Prior auth requiredFBA required

Likely CurrentVerified 2026-03-01

Alliance Health (NC LME-MCO)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Ambetter (Centene ACA Commercial)

CommercialNational

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

AmeriHealth Caritas

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

CommercialNational

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Anthem HealthKeepers Plus (VA Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Anthem/Elevance Medicare Advantage

CommercialNational

Prior auth required12mo initial authFBA required

VerifiedVerified 2026-03-16

Arizona Complete Health (AZ Medicaid)

Prior auth required6mo initial authFBA required

Likely CurrentVerified 2026-03-01

Arizona Medicaid (AHCCCS)

MedicaidNational

Prior auth required1mo initial authFBA required

Needs ReviewVerified 2026-03-01

Arkansas Blue Cross Blue Shield

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Arkansas Medicaid

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

BCBS Illinois (HCSC)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

BCBS Massachusetts

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

BCBS Texas (HCSC)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Blue Cross Blue Shield Federal Employee Program (FEP)

CommercialNational

Prior auth required12mo initial authFBA required

VerifiedVerified 2026-03-01

Blue Cross Blue Shield of Alabama

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Blue Cross Blue Shield of Kansas

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-17

Blue Cross Blue Shield of Kansas City

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Blue Cross Blue Shield of Louisiana

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Blue Cross Blue Shield of Mississippi

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Blue Cross Blue Shield of Missouri (Anthem)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-17

Blue Cross Blue Shield of Montana

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Blue Cross Blue Shield of Nebraska

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Blue Cross Blue Shield of New Mexico (HCSC)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Blue Cross Blue Shield of North Dakota (Noridian)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Blue Cross Blue Shield of Oklahoma (HCSC)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Blue Cross Blue Shield of Rhode Island

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-17

Blue Cross Blue Shield of Vermont

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-17

Blue Cross Blue Shield of Wyoming

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Blue Cross Complete of Michigan (Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Blue Shield of California

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Blue Shield Promise Health Plan (CA Medi-Cal)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

BlueCross BlueShield of South Carolina

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

BlueCross BlueShield of Tennessee

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Buckeye Health Plan (OH Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

California Medicaid (Medi-Cal)

Prior auth required12mo initial authFBA required

VerifiedVerified 2026-03-01

Capital BlueCross (PA)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

CareFirst BlueCross BlueShield (MD/DC/VA)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

CareFirst BlueCross BlueShield Community Health Plan (MD Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Carelon Behavioral Health (Beacon)

CommercialNational

Prior auth requiredFBA required

Likely CurrentVerified 2026-03-01

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

CommercialGA/OH

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Carolina Complete Health (NC Medicaid)

Prior auth required6mo initial authFBA required

Likely CurrentVerified 2026-03-01

Centene / WellCare / Ambetter

MedicaidNational

Prior auth required12mo initial authFBA required

VerifiedVerified 2026-03-01

GovernmentNational

Prior auth requiredFBA required

Needs ReviewVerified 2026-03-01

Cigna / Evernorth

CommercialNational

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Cigna Medicare Advantage

CommercialNational

Prior auth required12mo initial authFBA required

VerifiedVerified 2026-03-16

Colorado Medicaid (Health First Colorado)

Prior auth required6mo initial authFBA required

Likely CurrentVerified 2026-03-01

Community Health Plan of Washington (Apple Health)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Connecticut Medicaid (HUSKY)

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

Coordinated Care (WA Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Delaware Medicaid

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

Devoted Health (Medicare Advantage)

CommercialNational

Prior auth required12mo initial authFBA required

Likely CurrentVerified 2026-03-16

Driscoll Health Plan (TX Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Eastpointe (NC LME-MCO)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Prior auth requiredFBA required

Needs ReviewVerified 2026-03-01

eviCore Healthcare (ABA Auth Manager)

CommercialNational

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Excellus BlueCross BlueShield (NY)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Fidelis Care (NY Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Fidelis Care (NY)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Florida KidCare (CHIP)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Florida Medicaid (AHCA)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

GEHA (Federal Employee Health Benefits)

CommercialNational

Prior auth required12mo initial authFBA required

VerifiedVerified 2026-03-01

Geisinger Health Plan (PA)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Georgia Medicaid (DCH)

Prior auth requiredFBA required

Likely CurrentVerified 2026-03-01

Harvard Pilgrim Health Care

CommercialMA/ME/NH

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

Hawaii Med-QUEST

Prior auth required12mo initial authFBA required

Likely CurrentVerified 2026-03-01

Health Net (CA)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

HealthFirst (NY Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

HealthPartners (MN/WI)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Healthy Blue (BCBS Medicaid)

MedicaidLA/MO/NC/NE/SC

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

Healthy Blue Louisiana (LA Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Prior auth required6mo initial authFBA required

Likely CurrentVerified 2026-03-01

Horizon BCBS NJ

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

CommercialNational

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Humana Healthy Horizons (Medicaid)

MedicaidNational

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Humana Medicare Advantage

CommercialNational

Prior auth required12mo initial authFBA required

VerifiedVerified 2026-03-16

Prior auth requiredFBA required

Likely CurrentVerified 2026-03-01

IlliniCare Health (IL Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Illinois Medicaid (HFS)

MedicaidNational

Prior auth requiredFBA required

Likely CurrentVerified 2026-03-01

Independence Blue Cross (PA)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Indiana Medicaid (FSSA)

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

Inland Empire Health Plan (CA Medi-Cal)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

Iowa Total Care (IA Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Kaiser Permanente

CommercialNational

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

Kaiser Permanente Medicare Advantage

CommercialNational

Prior auth required12mo initial authFBA required

Likely CurrentVerified 2026-03-16

KanCare (Kansas Medicaid)

Prior auth requiredFBA required

Likely CurrentVerified 2026-03-01

Kentucky Medicaid

Prior auth requiredFBA required

Likely CurrentVerified 2026-03-01

Keystone First (PA Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

L.A. Care Health Plan (CA)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Louisiana Medicaid (Healthy Louisiana)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Magellan Health

CommercialNational

Prior auth requiredFBA required

Needs ReviewVerified 2026-03-01

Magnolia Health (MS Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

MaineCare (Maine Medicaid)

Prior auth requiredFBA required

Needs ReviewVerified 2026-03-01

Managed Health Services (IN Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Maryland Medicaid (MMCP)

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

Massachusetts Medicaid (MassHealth)

Prior auth requiredFBA required

Needs ReviewVerified 2026-03-01

Medica Health Plans (MN)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Medicare Part B

GovernmentNational

No prior auth12mo initial authFBA required

VerifiedVerified 2026-03-01

Mercy Care Plan (AZ Medicaid)

Prior auth required6mo initial authFBA required

Likely CurrentVerified 2026-03-01

Meridian Health Plan (IL/MI Medicaid)

Prior auth required6mo initial authFBA required

Likely CurrentVerified 2026-03-01

Michigan Medicaid (MDHHS)

Prior auth requiredFBA required

Likely CurrentVerified 2026-03-01

Minnesota Medicaid (DHS)

MedicaidNational

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Mississippi Medicaid

Prior auth requiredFBA required

Likely CurrentVerified 2026-03-01

Missouri Medicaid (MO HealthNet)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

CommercialOR/AK

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

Molina Healthcare

MedicaidNational

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Molina Healthcare of California

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Molina Healthcare of Colorado

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Molina Healthcare of Illinois

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Molina Healthcare of Indiana

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Molina Healthcare of Iowa

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Molina Healthcare of Michigan

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Molina Healthcare of Nevada

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Molina Healthcare of New Mexico

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Molina Healthcare of Ohio

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Molina Healthcare of Texas

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Molina Healthcare of Utah

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Molina Healthcare of Washington

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Molina Healthcare of Wisconsin

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Molina Medicare Advantage

CommercialNational

Prior auth required12mo initial authFBA required

Likely CurrentVerified 2026-03-16

Montana Medicaid

Prior auth required6mo initial authFBA required

Likely CurrentVerified 2026-03-01

Nebraska Medicaid

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

Nevada Medicaid

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

New Hampshire Medicaid

Prior auth requiredFBA required

Likely CurrentVerified 2026-03-01

New Jersey Medicaid (FamilyCare)

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

New Mexico Medicaid

Prior auth requiredFBA required

Needs ReviewVerified 2026-03-01

New York Medicaid (eMedNY)

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

North Carolina Medicaid (DHHS)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

North Dakota Medicaid

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

Ohio Medicaid (ODM)

Prior auth required12mo initial authFBA required

VerifiedVerified 2026-03-01

Oklahoma Medicaid (SoonerCare)

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

Optum Behavioral Health

CommercialNational

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Oregon Health Plan

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

CommercialNational

Prior auth required6mo initial authFBA required

Likely CurrentVerified 2026-03-16

PacificSource Health Plans

CommercialOR/ID/MT

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Paramount Advantage (OH Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Partners Health Management (NC LME-MCO)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Peach State Health Management (GA Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Pennsylvania CHIP (CHIP of PA)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Pennsylvania Medicaid (MA)

Prior auth requiredFBA required

Likely CurrentVerified 2026-03-01

CommercialWA/AK

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

Priority Health

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

Priority Partners (MD Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

CommercialOR/WA/UT/ID

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

Rhode Island Medicaid

Prior auth required12mo initial authFBA required

VerifiedVerified 2026-03-01

Sandhills Center (NC LME-MCO)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

SCAN Health Plan (CA Medicare Advantage)

Prior auth required12mo initial authFBA required

Likely CurrentVerified 2026-03-16

SelectHealth (UT)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

SilverSummit Healthplan (NV Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Simply Healthcare Plans (FL Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

South Carolina Medicaid (Healthy Connections)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

South Dakota Medicaid

Prior auth required1mo initial authFBA required

VerifiedVerified 2026-03-01

Sunflower Health Plan (KS Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Sunshine Health (FL Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Superior Health Plan (TX Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Tennessee Medicaid (TennCare)

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

Texas CHIP / STAR Kids

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Texas Medicaid (TMHP)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

TRICARE (Autism Care Demonstration)

GovernmentNational

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Trillium Health Resources (NC LME-MCO)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Tufts Health Plan

CommercialMA/NH/RI

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

Tufts Health Public Plans (ConnectorCare / Commonwealth Care Bridge)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-17

Tufts Health Together (MassHealth Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-17

UnitedHealthcare

CommercialNational

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

UnitedHealthcare Community Plan (Medicaid)

MedicaidNational

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

UnitedHealthcare Medicare Advantage

CommercialNational

Prior auth required12mo initial authFBA required

VerifiedVerified 2026-03-16

UPMC for You (PA Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

UPMC Health Plan (PA)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

Vaya Health (NC LME-MCO)

Prior auth required6mo initial authFBA required

Likely CurrentVerified 2026-03-01

Vermont Medicaid (Green Mountain Care)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Virginia Medicaid (DMAS)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

Viva Health (AL)

Prior auth required6mo initial authFBA required

Likely CurrentVerified 2026-03-01

Washington Medicaid (HCA)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

WellCare/Centene Medicare Advantage

CommercialNational

Prior auth required12mo initial authFBA required

Likely CurrentVerified 2026-03-16

CommercialIA/SD

Prior auth requiredFBA required

Likely CurrentVerified 2026-03-01

Wellpoint (Anthem Medicaid)

MedicaidNational

Prior auth required6mo initial authFBA required

Likely CurrentVerified 2026-03-01

WellSense Health Plan (MA/NH Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-01

West Virginia Medicaid

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

Western Sky Community Care (NM Medicaid)

Prior auth required6mo initial authFBA required

VerifiedVerified 2026-03-16

Wisconsin Medicaid

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

Wyoming Medicaid

Prior auth requiredFBA required

VerifiedVerified 2026-03-01

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