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4 active policy changes affecting ABA billing

ABA Payor Policy Change Log.

A public record of payor policy changes affecting ABA billing — authorization rules, unit tracking, documentation requirements, and rate changes. Sources are checked daily by monitoring agents; verified changes publish the same day.

Looking for the full change history with filters? See the payor changelog.

4
Active changes
4
Critical severity
8
Total tracked

Recent policy changes

Showing 8 of 8
CriticalMonitoringRate Change
New York Medicaid 12.5% rate cut (second phase) scheduled for April 2026
New York Medicaid·Effective 2026-04-01·NY
MediumMonitoringAge Limit
Hawaii proposes eliminating age 13 ABA coverage cap and $25,000 annual benefit limit
Hawaii Medicaid·Effective 2026-07-01·HI
CriticalMonitoringHour Cap
Indiana proposes 30-hour weekly cap and 3-year lifetime limit for comprehensive ABA
Indiana Medicaid·Effective 2026-07-01·IN
HighActiveDocumentation
BCBS Texas updates preservice review requirements for ABA
BCBS Texas·Effective 2026-04-01·TX
CriticalActiveUnit Tracking
Anthem shifts to weekly unit tracking for all ABA CPT codes
Anthem BCBS·Effective 2026-01-01·National — all Anthem BCBS states
MediumActiveCPT Coverage
Harvard Pilgrim expands ABA coverage to include Down Syndrome diagnoses
Harvard Pilgrim Health Care·Effective 2026-01-01·MA, ME, NH, RI
CriticalResolvedRate Change
NC Medicaid 10% ABA rate cut blocked by court injunction — rates restored
North Carolina Medicaid·Effective 2025-10-01·NC
HighActiveDocumentation
Horizon BCBS adds mandatory 6-month standardized reassessment requirement
Horizon BCBS (NJ)·Effective 2026-01-01·NJ

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The public log shows the most recent 8 of 8 changes. Subscribers get full action steps, a weekly email digest, and authorization rules for all 192 payors — including CPT modifier requirements and payor comparison.

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192 payors · 72 commercial · 114 Medicaid · 6 government