How do I stop losing ABA families to slow intake?

Respond to every inquiry the moment it arrives — across every channel, day and night — and complete intake before a competitor does. Carelu automates that first response and the full intake so no family waits, admitting more families without adding front-desk staff.

How does an AI intake agent work for ABA therapy?

It answers calls, chats, forms, and texts; collects the family's information and documents; verifies insurance eligibility; schedules the first appointment; and routes anything needing a human to your team — with a full record on every family.

Is Carelu HIPAA compliant?

Yes. Carelu is HIPAA compliant and SOC 2 Type II, and signs a BAA with every provider.

ABA Prior Authorization & Coverage by Payer: 484 Insurer Guides by State

Payer	Assessment (97151)	Treatment
Georgia Medicaid	Required	Required
CareSource (Georgia Medicaid CMO)	Required	Required
Peach State Health Plan (GA Medicaid CMO)	Required	Required
Amerigroup (GA Medicaid CMO)	Required	Required
Anthem BCBS Georgia	Required	Required
Aetna in Georgia	Required	Required
Cigna / Evernorth in Georgia	Not required for assessment codes 97151, 97152, 0362T	Required
UnitedHealthcare / Optum in Georgia	Required	Required

Payer	Assessment (97151)	Treatment
North Carolina Medicaid	Required	Required
Healthy Blue (NC)	Required	Required
AmeriHealth Caritas North Carolina	See guide	See guide
Carolina Complete Health	Required	Required
UnitedHealthcare Community Plan of North Carolina	Required	Required
WellCare of North Carolina	See guide	Required
Alliance Health (NC Tailored Plan)	Required	See guide
Trillium Health Resources (NC Tailored Plan)	Required	Required
Vaya Health (NC Tailored Plan)	Required	Required
Partners Health Management (NC Tailored Plan)	Required	Required
Aetna in North Carolina	Required	See guide
Cigna / Evernorth in North Carolina	Not required for assessment codes 97151, 97152, 0362T	Required
UnitedHealthcare / Optum in North Carolina	Required	Required
MedCost Benefit Services	See guide	See guide
Blue Cross Blue Shield of North Carolina	Not required for the initial evaluation	Required

Payer	Assessment (97151)	Treatment
Indiana Medicaid (IHCP)	Required	Required
Anthem BCBS Indiana (Medicaid)	Required	See guide
MHS — Managed Health Services (Indiana)	Required	Required
CareSource Indiana	Required	See guide
MDwise (Indiana)	Required	See guide
UnitedHealthcare Community Plan of Indiana	Required	Required
Aetna in Indiana	Required	Required
Cigna / Evernorth in Indiana	Not required for assessment codes 97151, 97152, 0362T	Required
UnitedHealthcare / Optum in Indiana	Required	Required
Anthem BCBS Indiana	See guide	See guide
Anthem Blue Cross and Blue Shield Indiana (commercial)	See guide	See guide
CareSource Indiana Marketplace	Required	Required

Payer	Assessment (97151)	Treatment
Virginia Medicaid (DMAS)	Not required	Required
Aetna Better Health of Virginia	Not required	Required
Anthem HealthKeepers Plus (VA)	Not required	Required
Humana Healthy Horizons in Virginia	Not required for 97151/97152 (off the PA list)	Required
Sentara Community Plan (VA)	Not required	Required
UnitedHealthcare Community Plan of Virginia	Not required	Required
Aetna in Virginia	Required	Required
Cigna / Evernorth in Virginia	See guide	See guide
UnitedHealthcare / Optum in Virginia	Required	Required
Anthem BCBS Virginia	Required	Required

Payer	Assessment (97151)	Treatment
TennCare (Tennessee Medicaid)	Required	Required
BlueCare Tennessee (BCBST)	Required	Required
UnitedHealthcare Community Plan of Tennessee	Required	Required
Wellpoint Tennessee (formerly Amerigroup)	Required	Required
TennCare Select	Required	Required
Aetna in Tennessee	Required	Required
Cigna / Evernorth in Tennessee	Not required for assessment codes 97151, 97152, 0362T	Required
UnitedHealthcare / Optum in Tennessee	Required	Required
Blue Cross Blue Shield Tennessee	See guide	See guide

Payer	Assessment (97151)	Treatment
Ohio Medicaid	See guide	See guide
CareSource Ohio	Required	Required
Buckeye Health Plan (OH)	Not required in-network	Required
Molina Healthcare of Ohio	See guide	See guide
Anthem BCBS Ohio (Medicaid)	See guide	See guide
UnitedHealthcare Community Plan of Ohio	See guide	Required
AmeriHealth Caritas Ohio	See guide	Required
Humana Healthy Horizons in Ohio	Required	Required
Aetna in Ohio	Required	See guide
Cigna / Evernorth in Ohio	Not required for assessment codes 97151, 97152, 0362T	Required
UnitedHealthcare / Optum in Ohio	Required	Required
Anthem BCBS Ohio	Required	Required

Payer	Assessment (97151)	Treatment
NJ FamilyCare (New Jersey Medicaid)	Required via the MCO	Required
Horizon NJ Health	Required	Required
Aetna Better Health of New Jersey	Required	Required
Fidelis Care New Jersey (formerly WellCare)	Required	Required
UnitedHealthcare Community Plan (NJ FamilyCare)	Required	Required
Wellpoint New Jersey (formerly Amerigroup)	Required	Required
Aetna in New Jersey	Required	Required
Cigna / Evernorth in New Jersey	Not required for assessment codes 97151, 97152, 0362T	Required
UnitedHealthcare / Optum in New Jersey	Required	Required
Horizon Blue Cross Blue Shield of New Jersey	Required	Required

Payer	Assessment (97151)	Treatment
Maryland Medicaid (Medical Assistance)	Required	Required
Johns Hopkins US Family Health Plan	Required	Required
CareFirst BlueCross BlueShield (Maryland)	See guide	Required
Aetna in Maryland	Required	Required
Cigna / Evernorth in Maryland	Not required for assessment codes 97151, 97152, 0362T	Required
UnitedHealthcare / Optum in Maryland	Required	Required

Payer	Assessment (97151)	Treatment
Health First Colorado (Colorado Medicaid)	Required	Required
Aetna in Colorado	Required	Required
Cigna / Evernorth in Colorado	Not required for assessment codes 97151, 97152, 0362T	Required
UnitedHealthcare / Optum in Colorado	Required	Required
Anthem BCBS Colorado	Required	Required

Payer	Assessment (97151)	Treatment
Utah Medicaid	Not required	Required
Select Health (Utah)	Community Care (Medicaid) members: none	Community Care (Medicaid) members: routes to Utah Medicaid FFS
Aetna in Utah	Required	Required
Cigna / Evernorth in Utah	See guide	See guide
UnitedHealthcare / Optum in Utah	Required	Required

Payer	Assessment (97151)	Treatment
AHCCCS (Arizona Medicaid)	See guide	See guide
Mercy Care (AZ)	Not required for 97151 and 97152	Required for 97153–97158
UnitedHealthcare Community Plan of Arizona	Not required	Required for all treatment codes
Arizona Complete Health - Complete Care Plan	See guide	Required per CP.BH.104
Banner-University Family Care	Not for in-network providers	Required for 97155, 97156, 97157 and 97158 before services start, on Banner’s ABA Prior Authorization Form…
Blue Cross Blue Shield of Arizona Health Choice	See guide	See guide
Molina Healthcare of Arizona	See guide	Required
DES/DDD (Arizona Division of Developmental Disabilities)	Follows the member's DDD Health Plan	Through the member's DDD Health Plan (Mercy Care DD or UHCCP DD), on the same ABA PA machinery as their ACC…
Aetna in Arizona	Required	Required
Cigna / Evernorth in Arizona	Not required for assessment codes 97151, 97152, 0362T	Required
UnitedHealthcare / Optum in Arizona	Required	Required

Payer	Assessment (97151)	Treatment
New York Medicaid (NYS DOH / eMedNY)	FFS: NO prior authorization	FFS: none stated
Fidelis Care New York (Centene)	Authorization-based	Required
UnitedHealthcare Community Plan of New York	Required	Required
Anthem Blue Cross and Blue Shield HP (NY Medicaid)	Required	Required
Healthfirst (New York)	See guide	See guide
MetroPlusHealth (NY Medicaid)	See guide	Required
EmblemHealth (NY Medicaid)	See guide	See guide
Molina Healthcare of New York	Required	Required
Excellus BlueCross BlueShield (NY Medicaid)	See guide	See guide
MVP Health Plan (NY Medicaid)	Required	Required
CDPHP (NY Medicaid)	See guide	See guide
Independent Health (NY Medicaid)	See guide	See guide
Highmark Western and Northeastern New York (NY Medicaid)	Required	Required
Martin’s Point US Family Health Plan	Required	Required
Aetna in New York	Required	Required
Cigna / Evernorth in New York	Not required for assessment codes 97151, 97152, 0362T	Required
UnitedHealthcare / Optum in New York	Required	Required
Anthem BCBS New York (formerly Empire)	Required	Required

Payer	Assessment (97151)	Treatment
New Mexico Medicaid (Turquoise Care)	Not required	Required for 97153 only (97155/97156 are PA-free)
Blue Cross and Blue Shield of New Mexico (Turquoise Care)	State baseline applies via the shared Turquoise Care LOC guidelines	Required
Presbyterian Health Plan (Turquoise Care)	Required	Required on every ABA treatment code
Molina Healthcare of New Mexico (Turquoise Care)	See guide	See guide
UnitedHealthcare Community Plan of New Mexico (Turquoise Care)	Not required	Required only for 97153 and 0373T
Aetna in New Mexico	Required	See guide
Cigna / Evernorth in New Mexico	Not required for assessment codes 97151, 97152, 0362T	Required
UnitedHealthcare / Optum in New Mexico	Required	Required

Payer	Assessment (97151)	Treatment
MO HealthNet (Missouri Medicaid)	Required	Required
Aetna in Missouri	Required	Required
Cigna / Evernorth in Missouri	Not required for assessment codes 97151, 97152, 0362T	Required
UnitedHealthcare / Optum in Missouri	Required	Required
Anthem BCBS Missouri	See guide	See guide

Payer	Assessment (97151)	Treatment
Texas Medicaid (THSteps-CCP)	Required	Required
Superior HealthPlan (TX)	Required	Required
Texas Children's Health Plan	Required	Required
Wellpoint (formerly Amerigroup Texas)	Required	Required
UnitedHealthcare Community Plan of Texas	Required (state benefit)	Required
Aetna Better Health of Texas	Required	Required
Molina Healthcare of Texas	See guide	See guide
Community First Health Plans	Required	Required
Driscoll Health Plan	Required	Required
Community Health Choice	Required	Required
Blue Cross Blue Shield of Texas (Medicaid)	Required	Required
Cook Children's Health Plan	Required	Required
Parkland Community Health Plan	Required	Required
El Paso Health	Required	Required
FirstCare Health Plans	Required	Required
RightCare from Scott and White Health Plan (dba Baylor Scott & White Health Plan)	Required	Required
Dell Children's Health Plan	Required	Required
Aetna in Texas	Required	Required
Cigna / Evernorth in Texas	See guide	See guide
UnitedHealthcare / Optum in Texas	Required	Required

Payer	Assessment (97151)	Treatment
MassHealth (Massachusetts Medicaid)	Required	Required
Massachusetts Behavioral Health Partnership (MBHP)	Required	Required
WellSense Health Plan	Required	Required
Tufts Health Together (Point32Health)	Required	Required
Fallon Health (MassHealth ACPPs)	Required	Required
Health New England — BeHealthy Partnership	Required	Required
Mass General Brigham Health Plan (MassHealth ACPP)	Required	Required
Aetna in Massachusetts	Required	Required
Cigna / Evernorth in Massachusetts	Not required for assessment codes 97151, 97152, 0362T	Required
UnitedHealthcare / Optum in Massachusetts	Required	Required
Blue Cross Blue Shield of Massachusetts	Required	Required for every ABA treatment code (97153–97158, 0373T) on HMO, POS, PPO and Indemnity commercial plans

Payer	Assessment (97151)	Treatment
Florida Medicaid — Behavior Analysis Services (AHCA)	Required	Required
Sunshine Health (FL)	Required	Required
Children's Medical Services (CMS) Health Plan (FL)	From 10/1/2026 (Molina): not for 97151	Required
Simply Healthcare Plans (FL)	Required	Required
UnitedHealthcare Community Plan of Florida	Required	Required
Humana Healthy Horizons in Florida	Required	Required
Aetna Better Health of Florida	Required	Required
Molina Healthcare of Florida	Not for 97151	Required
Community Care Plan (FL)	Required	Required
Florida Community Care	Required	Required
Aetna in Florida	Required	Required
Cigna / Evernorth in Florida	Not required for assessment codes 97151, 97152, 0362T	Required
UnitedHealthcare / Optum in Florida	Required	Required
Florida Blue (Blue Cross and Blue Shield of Florida)	Required	Required

Payer	Assessment (97151)	Treatment
KanCare (Kansas Medicaid)	Required	Required
Sunflower Health Plan (KS)	Required	Required
UnitedHealthcare Community Plan of Kansas	Required	Required
Healthy Blue Kansas	Required	Required
Aetna in Kansas	Required	Required
Cigna / Evernorth in Kansas	Not required for assessment codes 97151, 97152, 0362T	Required
UnitedHealthcare / Optum in Kansas	Required	Required

Payer	Assessment (97151)	Treatment
Nebraska Medicaid (Heritage Health)	MCO-administered	Required
Nebraska Total Care (Centene)	Required	Required
Molina Healthcare of Nebraska	See guide	Required
UnitedHealthcare Community Plan of Nebraska	Required	Required
Aetna in Nebraska	Required	Required
Cigna / Evernorth in Nebraska	Not required for assessment codes 97151, 97152, 0362T	Required
UnitedHealthcare / Optum in Nebraska	Required	Required
Blue Cross Blue Shield Nebraska	Required	Required
Ambetter from Nebraska Total Care	Required	Required

Payer	Assessment (97151)	Treatment
Idaho Medicaid	Not before the initial assessment	Required
Blue Cross of Idaho	See guide	See guide
Regence BlueShield of Idaho	Not required except for FEP	See guide
Aetna in Idaho	Required	See guide
Cigna / Evernorth in Idaho	Not required for assessment codes 97151, 97152, 0362T with an autism diagnosis, when the provider is…	Required
UnitedHealthcare / Optum in Idaho	Required	Required

Payer	Assessment (97151)	Treatment
Iowa Medicaid (IA Health Link)	See guide	See guide
Iowa Total Care (Centene)	See guide	Required in practice: ABA is reviewed against CP.BH.104 initiation and continuation criteria in six-month…
Wellpoint Iowa (formerly Amerigroup Iowa)	See guide	See guide
Molina Healthcare of Iowa	See guide	See guide
Wellmark Blue Cross and Blue Shield of Iowa	See guide	See guide
Aetna in Iowa	Required	Required
Cigna in Iowa	Not required	Required
UnitedHealthcare in Iowa	Required	Required

Payer	Assessment (97151)	Treatment
Oklahoma Medicaid (SoonerCare / SoonerSelect) - Oklahoma Health Care Authority	Required	Required
Aetna Better Health of Oklahoma	See guide	Required
Centene - Oklahoma Complete Health	Required	Required for 97153, 97155 and 97156 for all providers
Humana Healthy Horizons in Oklahoma	Required	Required
Aetna in Oklahoma	Required	Required
Cigna / Evernorth in Oklahoma	Not required for 97151, 97152 or 0362T "with a diagnosis of autism, as long as the provider is independently…	Required
UnitedHealthcare in Oklahoma	Required	Required
Blue Cross and Blue Shield of Oklahoma	Not on the PA code list	Required

Payer	Assessment (97151)	Treatment
Michigan Medicaid	See guide	Required
Detroit Wayne Integrated Health Network (DWIHN)	See guide	Required
Oakland Community Health Network (OCHN)	See guide	Required
Macomb County Community Mental Health (MCCMH)	MCCMH requests authorization for each six-month assessment/evaluation period, 14 or more days before the…	Required
Mid-State Health Network (MSHN)	See guide	Required
Southwest Michigan Behavioral Health (SWMBH)	See guide	Required
Blue Cross Blue Shield of Michigan	Required for BCN HMO plans and for Blue Cross PPO fully insured and select self-funded groups	Required through Blue Cross Behavioral Health for all BCN HMO plans and for Blue Cross PPO fully insured and…
Priority Health (Michigan)	Required	Required
Health Alliance Plan (HAP) — Michigan	See guide	Required
Aetna in Michigan	Required	See guide
Cigna / Evernorth in Michigan	Not required for 97151, 97152 or 0362T with an autism diagnosis when the provider is independently licensed…	Required
UnitedHealthcare (Optum Behavioral Health) in Michigan	See guide	Required

Payer	Assessment (97151)	Treatment
Hawaii Medicaid (Med-QUEST / QUEST Integration)	See guide	Required
AlohaCare (QUEST Integration)	Required	Required for all treatment services (97153–97158, 0373T)
Ohana Health Plan (WellCare of Hawaii)	Required	Required
UnitedHealthcare Community Plan of Hawaii	See guide	Required
Kaiser Permanente Hawaii (QUEST Integration)	See guide	Required for outside providers
Hawaii Medical Service Assoc (HMSA) - Blue Cross Blue Shield of Hawaii	See guide	Required
Aetna in Hawaii	Required	Required
Cigna / Evernorth in Hawaii	Not required for 97151, 97152 and 0362T with an autism diagnosis, when the provider is independently licensed…	Required
UnitedHealthcare / Optum in Hawaii	See guide	Required

Payer	Assessment (97151)	Treatment
Medi-Cal (California Medicaid)	See guide	Required
L.A. Care Health Plan (Medi-Cal)	Required	Required
Health Net Community Solutions (Medi-Cal) / CalViva Health	Required	Required
Inland Empire Health Plan (IEHP, Medi-Cal)	Required	Required
CalOptima Health (Medi-Cal)	Required	Required
Anthem Blue Cross Partnership Plan (Medi-Cal)	Required through the authorization request	Required
Molina Healthcare of California (Medi-Cal)	See guide	Required
Kaiser Permanente (Medi-Cal)	Required	Required
Partnership HealthPlan of California (Medi-Cal)	Required	Required
Kaiser Permanente (California commercial)	Required as a Kaiser referral, not a provider-filed PA	Required as a Kaiser authorization
Blue Shield of California	Required	See guide
Anthem Blue Cross (California commercial)	Required	Required
Health Net of California (commercial)	Required	Required
Aetna in California	See guide	See guide
Cigna in California	Not required for standard in-network requests	Required
UnitedHealthcare in California	Required	Required

Payer	Assessment (97151)	Treatment
Pennsylvania Medicaid (Medical Assistance)	Fee-for-service: not required	Fee-for-service: required for BHT-ABA (97153, 97152) and Assistant BC-ABA (97153 U8, 97152 U8) and group ABA…
Community Care Behavioral Health Organization (HealthChoices BH-MCO)	No prior authorization	Required
Community Behavioral Health (CBH) — Philadelphia HealthChoices BH-MCO	Yes, but on a written order alone	Required
Magellan Behavioral Health of Pennsylvania (HealthChoices BH-MCO)	Registration only	Required
PerformCare (HealthChoices BH-MCO, AmeriHealth Caritas family)	Registration only	Required
Carelon Health of Pennsylvania (HealthChoices BH-MCO; formerly Beacon / Value Behavioral Health)	No	Required
Highmark Blue Cross Blue Shield in Pennsylvania	Required	Required
Capital Blue Cross in Pennsylvania	Required for Commercial/CHIP	Required
Independence Blue Cross in Pennsylvania	Required	Required
UPMC Health Plan in Pennsylvania	See guide	See guide
Geisinger Health Plan in Pennsylvania	Not required in network for autism	Not required in network for ASD
Aetna in Pennsylvania	Required	Required
Cigna / Evernorth in Pennsylvania	Not required for assessment codes 97151, 97152 or 0362T with an autism diagnosis, if the provider is…	Required
UnitedHealthcare / Optum in Pennsylvania	Required	Required, as a separate treatment authorization on Provider Express

Payer	Assessment (97151)	Treatment
New Hampshire Medicaid	Fee-for-service: yes	Fee-for-service: yes for 97153, 97155 and 97156 (Form 272A to DHHS Medicaid Medical Services)
AmeriHealth Caritas New Hampshire	Required	Required for every ABA treatment code
NH Healthy Families	Required	Required
WellSense Health Plan (New Hampshire)	Required	Required
Anthem Blue Cross and Blue Shield New Hampshire	Yes: 97151 and 97152 are on the New Hampshire precertification list (updated 10/15/26), reviewed by Anthem on…	Yes: 97153–97158, 0362T and 0373T are all on the NH precertification list
Harvard Pilgrim Health Care (New Hampshire)	Yes: 97151 and 97152 require prior authorization for Harvard Pilgrim commercial products (MNG effective July…	Yes: 97153–97158, 0362T and 0373T require prior authorization
Aetna in New Hampshire	Required: all ten ABA codes, 97151 included, are on Aetna’s behavioral health precertification list	See guide
Cigna / Evernorth in New Hampshire	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	Required: completed assessment and treatment plan attached to the ABA Prior Authorization Form
UnitedHealthcare / Optum in New Hampshire	Required: the ABA Supplemental Clinical Criteria require prior authorization for ABA "unless otherwise…	See guide

Payer	Assessment (97151)	Treatment
Wisconsin Medicaid (ForwardHealth)	No, up to a limit: ForwardHealth covers "up to 96 units/24 hours of behavior identification assessment…	Required
Aetna in Wisconsin	See guide	See guide
Cigna / Evernorth in Wisconsin	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	Required: after the assessment, submit the treatment plan on the Applied Behavior Analysis Prior…
UnitedHealthcare / Optum in Wisconsin	See guide	See guide
Anthem Blue Cross and Blue Shield Wisconsin	See guide	See guide

Payer	Assessment (97151)	Treatment
South Carolina Healthy Connections Medicaid	Fee-for-service: no	Fee-for-service: yes
Absolute Total Care	Required	Yes: all ABA codes 97151–97158 are on the list, and the provider manual marks ASD services "Prior…
Healthy Blue by BlueChoice HealthPlan	See guide	Yes: "Prior authorization for all covered services is required, excluding diagnostic services"
Molina Healthcare of South Carolina	See guide	Yes: ABA for treatment of ASD is on Molina’s South Carolina Medicaid pre-service review (prior authorization)…
First Choice by Select Health of South Carolina	Yes: "Prior authorization is required for all ASD services, including assessments and treatments"	Yes, through NaviNet or the ASD Treatment Request form faxed to Behavioral Health UM (1-888-796-5521)
Humana Healthy Horizons in South Carolina	See guide	Yes: Humana lists an Applied Behavioral Analysis Authorization Form among its South Carolina behavioral…
Aetna in South Carolina	Required: all ten ABA codes, 97151 included, are on Aetna’s behavioral health precertification list	See guide
Cigna / Evernorth in South Carolina	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	Required: the completed assessment and treatment plan go with the Applied Behavior Analysis Prior…
UnitedHealthcare / Optum in South Carolina	Required: the ABA Supplemental Clinical Criteria say "Prior authorization is required for ABA (unless…	See guide
BlueCross BlueShield of South Carolina	Required: BCBSSC’s standard prior-authorization list includes "ABA for Autism" with 97151 through 97158,…	Required: autism PA requests go to Companion Benefit Alternatives (CBA) at autismsupport@companiongroup.com,…

Payer	Assessment (97151)	Treatment
Kentucky Medicaid	See guide	See guide
Aetna Better Health of Kentucky	Required	Yes, for 97153–97158 from 6/25/2025
Humana Healthy Horizons in Kentucky	Required	Yes, 97153–97158, reinstated July 1, 2025
Passport by Molina Healthcare	No	Yes, after 48 units: "Prior authorization required after 48 units, for any combination of CPT Codes listed,…
UnitedHealthcare Community Plan of Kentucky	Required	Yes, 97153–97158, submitted on Provider Express (separate "ABA treatment requests" path)
WellCare of Kentucky	Required	Yes for every ABA code: the Q4 2026 list shows 97153, 97154, 97155, 97156 and 97158 requiring authorization…
Aetna in Kentucky	Required: all ten ABA codes, 97151 included, are on Aetna’s behavioral health precertification list	See guide
Cigna / Evernorth in Kentucky	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	Required: treatment requests with the completed assessment and treatment plan
UnitedHealthcare / Optum in Kentucky	Required: the ABA Supplemental Clinical Criteria require prior authorization for ABA "unless otherwise…	See guide
Anthem Blue Cross and Blue Shield (Kentucky)	See guide	Required: ABA is on the precertification list for "OH, IN, KY Blues products" (updated January 1, 2026), with…

Payer	Assessment (97151)	Treatment
Washington Apple Health (Medicaid)	No for fee-for-service: 97151 and 0362T carry no PA on HCA’s fee schedule and billing guide (97151 is limited…	Yes for 97153, 0373T, 97154, 97158 and the H2020 day program
Community Health Plan of Washington	See guide	Required
Coordinated Care of Washington	See guide	Required
Molina Healthcare of Washington	See guide	See guide
UnitedHealthcare Community Plan of Washington	See guide	Required
Wellpoint Washington	See guide	Required
Aetna in Washington	Required: all ten ABA codes, 97151 included, are on Aetna’s behavioral health precertification list	See guide
Cigna / Evernorth in Washington	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	Required: completed assessment and treatment plan attached to the ABA Prior Authorization Form
UnitedHealthcare / Optum in Washington	Required: Optum’s ABA Supplemental Clinical Criteria say "Prior authorization is required for ABA" unless…	See guide
Premera Blue Cross	Yes: Premera’s October 2026 code lists put ABA among behavioral health services requiring prior…	Yes: 97153, 97154, 97155, 97156, 97158 and 0373T are "Prior Authorization Required" on the individual-plan…
Regence BlueShield (Washington)	See guide	See guide

Payer	Assessment (97151)	Treatment
Connecticut Medicaid (HUSKY Health)	Required	Required
Carelon Behavioral Health of Connecticut (CT BHP)	Required	Yes, through ProviderConnect: initial treatment authorizations up to 90 days, then up to 6 months, with…
Anthem Blue Cross and Blue Shield (Connecticut)	See guide	Required
Aetna in Connecticut	Required: all ten ABA codes, including 97151, are on Aetna’s behavioral health precertification list	See guide
Cigna / Evernorth in Connecticut	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	Required: request treatment authorization up to 30 days before or two weeks after the start date
UnitedHealthcare / Optum in Connecticut	Required: Optum’s ABA Supplemental Clinical Criteria say “Prior authorization is required for ABA *(unless…	See guide
ConnectiCare (Connecticut)	See guide	Required

Payer	Assessment (97151)	Treatment
Illinois Medicaid (HFS)	Fee-for-service: only beyond 6 hours	Fee-for-service: yes
Aetna Better Health of Illinois	Notification instead of PA since January 1, 2026: for 97151 and 97152, “if Aetna Better Health of Illinois…	See guide
Blue Cross Community Health Plans (BCBSIL Medicaid)	97151 and 97152 are on the BCCHP prior authorization code list	Yes beyond the notification window: 97153–97158, 0362T and 0373T are on the code list (ABA Clinical Service…
CountyCare Health Plan (Cook County)	No	Required
Meridian (Meridian Health Plan of Illinois)	Notification, not PA: “Effective May 1, 2026, providers must notify Meridian within 24 hours of conducting…	Required
Molina Healthcare of Illinois	No	Concurrent review only: “ABA services are no longer eligible for prior authorization and require concurrent…
YouthCare (HealthChoice Illinois for DCFS youth)	Notification: the September 2026 manual lists “Adaptive Behavior Treatment – initial assessment” under…	Yes: “Adaptive Behavior Treatment (initial assessment requires notification within 24 hours)” is under “Prior…
Aetna in Illinois	See guide	See guide
Cigna / Evernorth in Illinois	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	See guide
UnitedHealthcare / Optum in Illinois	See guide	See guide
Blue Cross and Blue Shield of Illinois (HCSC)	See guide	See guide

Payer	Assessment (97151)	Treatment
Louisiana Medicaid (Healthy Louisiana)	Required	Required
Aetna Better Health of Louisiana	Required	Required
AmeriHealth Caritas Louisiana	Required	Required
Healthy Blue (Louisiana Medicaid)	Required	Yes: 97153–97158, 0362T and 0373T are on the PA list
Humana Healthy Horizons in Louisiana	Required	Required
Louisiana Healthcare Connections	Required	Required
Aetna in Louisiana	Required: all ten ABA codes, 97151 included, are on Aetna’s behavioral health precertification list	Required: 97153–97158, 0362T and 0373T are on the precertification list
Cigna / Evernorth in Louisiana	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	Required: attach the completed assessment and treatment plan to the ABA Prior Authorization Form
UnitedHealthcare in Louisiana	See guide	Required: "Prior authorization is required for ABA *(unless otherwise specified or mandated by contract or…
Blue Cross and Blue Shield of Louisiana (Louisiana Blue)	See guide	Required: "Authorization is required for Applied Behavioral Analysis services"

Payer	Assessment (97151)	Treatment
Oregon Health Plan (Medicaid)	Fee-for-service (open card): no	Fee-for-service: yes for 97153–97157 (fee schedule "PA")
Health Share of Oregon	Required	Yes, via CareOregon Connect or fax, with a comprehensive treatment plan
Trillium Community Health Plan (Oregon)	See guide	Yes: ABA treatment goes through Trillium’s prior-authorization process with its Applied Behavioral Analysis…
PacificSource Community Solutions (Oregon)	Not for a standard assessment: PA "is not required if CPT code 97151 is billed for 32 or fewer units (8 hours…	Yes: "Prior Authorization is required for ABA services," requested in increments of up to six months
Jackson Care Connect	An authorization is submitted, but CareOregon approves ABA assessment requests for JCC members "without the…	Yes, via CareOregon Connect or fax, with a comprehensive treatment plan and units for a six-month…
Columbia Pacific CCO	An authorization is submitted, but CareOregon approves ABA assessment requests for CPCCO members "without the…	Yes, via CareOregon Connect or fax, with a comprehensive treatment plan and units for a six-month…
InterCommunity Health Network CCO (IHN-CCO)	Yes: IHN’s 2026 Prior Authorization Code List puts 97151 and 97152 under "Applied Behavioral therapy (ABA)…	Yes: 97153–97157 (and 99366/99368) are on the same 2026 code list
Umpqua Health Alliance	See guide	Yes: ABA is listed as an in-network behavioral health service requiring PA, authorized for six months at a…
Eastern Oregon CCO (EOCCO)	Yes: EOCCO’s Prior Authorization List (September 2026) lists 97151 through 97158 "Applied Behavior Analysis…	Yes: the same list covers 97153–97158
Yamhill Community Care (YCCO)	Yes: YCCO’s PA list (as of 1/29/2026) carries 97151, 97152 and 0362T as active "Applied Behavioral Analysis"…	Yes: 97153–97156, 97158 and 0373T are on the PA list
Cascade Health Alliance	Yes: CHA’s BH Auth Grid (6/24/2026) requires "PA every 6 months for codes: 97151, 97152, 97153, 97154, 97155,…	Yes: same grid row, PA every six months for 97153–97156
Advanced Health	See guide	See guide
AllCare CCO	See guide	See guide
Aetna in Oregon	Required: all ten ABA codes, 97151 included, are on Aetna’s behavioral health precertification list	See guide
Cigna / Evernorth in Oregon	See guide	See guide
UnitedHealthcare / Optum in Oregon	Required: the Optum ABA Supplemental Clinical Criteria say "Prior authorization is required for ABA" unless…	See guide
Regence BlueCross BlueShield of Oregon	See guide	See guide

Payer	Assessment (97151)	Treatment
Minnesota Medical Assistance (EIDBI)	No for the first CMDE each calendar year	Required
Blue Plus (Blue Cross and Blue Shield of Minnesota) — Medical Assistance	See guide	Required
HealthPartners — Minnesota Health Care Programs	No for 97151 per HealthPartners’ EIDBI policy, whose prior-authorization code list covers 0373T and…	Yes: "Prior authorization is required" for 0373T, 97153, 97154, 97155, 97156 and 97157, reviewed by the…
Hennepin Health	Not on Hennepin Health’s EIDBI prior-authorization list, which names 97153, 97154, 0373T, 97155, 97156, 97157…	Yes: 97153UB, 97154UB, 0373T, 97155UB, 97156UB, 97157UB and H0046UB need prior authorization
IMCare (Itasca Medical Care)	See guide	See guide
Medica — Minnesota Health Care Programs	See guide	"Select services require authorization
Medica One Health Plan (formerly UCare Medical Assistance)	See guide	"Select services require authorization
PrimeWest Health	No: "The annual CMDE" is on PrimeWest’s list of services that "do not require authorization prior to service…	Yes: individual, group and higher-intensity intervention, family/caregiver training and observation and…
South Country Health Alliance	See guide	Yes: "Authorization Required - authorization cannot exceed 180 day time span" for 97153, 97154, 97155, 97156,…
Aetna in Minnesota	Required: all ten ABA codes, 97151 included, are on Aetna’s behavioral health precertification list	See guide
Cigna / Evernorth in Minnesota	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	See guide
UnitedHealthcare / Optum in Minnesota	Required: "Prior authorization is required for ABA *(unless otherwise specified or mandated by contract or…	See guide
Blue Cross and Blue Shield of Minnesota	See guide	See guide

Payer	Assessment (97151)	Treatment
MaineCare (Maine Medicaid)	There is no separate assessment code to authorize: Section 28 bills ABA only as H2021 U1 HK and lists no…	Required
Anthem Blue Cross and Blue Shield (Maine)	See guide	Yes: "Applied behavior analysis (ABA)" is on the Maine precertification list under behavioral health…
Aetna in Maine	Required: all ten ABA codes, 97151 included, are on Aetna’s behavioral health precertification list	See guide
Cigna / Evernorth in Maine	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	Required: after the assessment and treatment plan, submit the Applied Behavior Analysis Prior Authorization…
UnitedHealthcare / Optum in Maine	Required: Optum’s ABA Supplemental Clinical Criteria say "Prior authorization is required for ABA" unless…	See guide
Harvard Pilgrim Health Care (Maine)	Yes: 97151 and 97152 require prior authorization for Harvard Pilgrim commercial products (MNG effective July…	Yes: 97153–97158, 0362T and 0373T require prior authorization

Payer	Assessment (97151)	Treatment
Vermont Medicaid (Green Mountain Care / DVHA)	No	Required
Blue Cross and Blue Shield of Vermont	No	No for Blue Cross VT’s own members since 2025: prior approval was removed from all ABA codes ("Prior approval…
Aetna in Vermont	Required: all ten ABA codes, 97151 included, are on Aetna’s behavioral health precertification list	See guide
Cigna / Evernorth in Vermont	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	Required: treatment is authorized on EN0499 criteria with the completed assessment and treatment plan
UnitedHealthcare / Optum in Vermont	Required: the ABA Supplemental Clinical Criteria say prior authorization is required for ABA "unless…	See guide

Payer	Assessment (97151)	Treatment
Alabama Medicaid	No for the initial 97151 assessment, according to both the Chapter 37 code table and the February 2026 fee…	Required
Aetna in Alabama	Required: all ten ABA codes, 97151 included, are on Aetna’s behavioral health precertification list	See guide
Cigna / Evernorth in Alabama	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	Required: completed assessment and treatment plan submitted with the ABA prior authorization request
UnitedHealthcare / Optum in Alabama	Required: Optum’s ABA Supplemental Clinical Criteria say "prior authorization is required for ABA (unless…	See guide
Blue Cross and Blue Shield of Alabama	Required	Required, through Lucet WebPass

Payer	Assessment (97151)	Treatment
South Dakota Medicaid	Required	Required
Wellmark Blue Cross and Blue Shield of South Dakota	See guide	See guide
Aetna in South Dakota	Required: all ten ABA codes, 97151 included, are on Aetna’s behavioral health precertification list	See guide
Cigna / Evernorth in South Dakota	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	Required: completed assessment and treatment plan attached to the ABA Prior Authorization Form
UnitedHealthcare / Optum in South Dakota	Required: Optum’s ABA Supplemental Clinical Criteria say "Prior authorization is required for ABA" unless…	See guide

Payer	Assessment (97151)	Treatment
Nevada Medicaid	No	Required
Anthem Blue Cross and Blue Shield Healthcare Solutions (Nevada Medicaid)	See guide	Required
CareSource Nevada (Medicaid)	No	Required
Health Plan of Nevada (Nevada Medicaid)	See guide	Yes, for all ABA therapy services from November 17, 2025, reviewed by HPN’s Behavioral Health team under…
Molina Healthcare of Nevada (Medicaid)	See guide	See guide
SilverSummit Healthplan (Nevada Medicaid)	See guide	Required
Aetna in Nevada	Required: all ten ABA codes, 97151 included, are on Aetna’s behavioral health precertification list	See guide
Cigna / Evernorth in Nevada	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	Required: after the assessment and treatment plan, complete the Applied Behavior Analysis Prior Authorization…
UnitedHealthcare / Optum in Nevada	Required on Optum-managed plans: the ABA Supplemental Clinical Criteria require prior authorization for ABA…	See guide
Anthem Blue Cross and Blue Shield Nevada	See guide	See guide

Payer	Assessment (97151)	Treatment
Montana Medicaid	No prior authorization for the initial span	Not for the first 180 calendar days or 1,260 units, whichever comes first
Aetna in Montana	Required: all ten ABA codes, 97151 included, are on Aetna’s behavioral health precertification list	See guide
Cigna / Evernorth in Montana	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	Required: the completed assessment and treatment plan go with the Applied Behavior Analysis Prior…
UnitedHealthcare / Optum in Montana	Required: Optum’s ABA Supplemental Clinical Criteria say "Prior authorization is required for ABA" unless…	See guide
Blue Cross and Blue Shield of Montana	See guide	Required: 97153–97158, 0362T and 0373T are on BCBSMT’s 2026 behavioral health PA code list, requested on the…

Payer	Assessment (97151)	Treatment
Alaska Medicaid	No	No, since July 1, 2025: regulation project 2024200550 set out to "remove certain prior authorization…
Aetna in Alaska	Required: all ten ABA codes, 97151 included, are on Aetna’s behavioral health precertification list	See guide
Cigna / Evernorth in Alaska	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	Required: completed assessment and treatment plan attached to the ABA Prior Authorization Form
UnitedHealthcare / Optum in Alaska	Required: the ABA Supplemental Clinical Criteria require prior authorization for ABA "unless otherwise…	See guide
Premera Blue Cross Blue Shield of Alaska	Required on individual plans: 97151 and 0362T are "Prior Authorization Required" on Premera Alaska’s October…	Required: 97153, 97154, 97155, 97156, 97158 and 0373T are "Prior Authorization Required" on the individual…

Payer	Assessment (97151)	Treatment
North Dakota Medicaid	Required	Required
Blue Cross Blue Shield of North Dakota	See guide	See guide
Aetna in North Dakota	Required: all ten ABA codes, 97151 included, are on Aetna’s behavioral health precertification list	See guide
Cigna / Evernorth in North Dakota	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	Required: the completed assessment and treatment plan go with the ABA prior authorization request
UnitedHealthcare / Optum in North Dakota	Required: Optum’s ABA Supplemental Clinical Criteria say "Prior authorization is required for ABA" unless…	See guide

Payer	Assessment (97151)	Treatment
Arkansas Medicaid	Required	Yes, for every ABA service (97153, 97155, 97156): “Prior authorization is required for an applied behavior…
Arkansas Total Care	Not for network providers	Only for non-participating providers, per the Pre-Auth Check (queried October 18, 2026): 97153, 97154, 97155,…
CareSource PASSE	Yes: “All covered services must be reviewed for medical necessity prior to the service,” and the covered…	Yes: “A review of medical necessity is required prior to any ABA service provision” (PY-1616)
Empower Healthcare Solutions	Yes: 97151 is on Empower’s PA list	Yes: 97153, 97155 and 97156 are on the PA list (PA required)
Summit Community Care	Yes: 97151 and 97152 are on Summit’s list of services requiring prior authorization (updated 2/11/2026)	Yes: 97153, 97154, 97155, 97156 and 97158 are on the PA list (only 97153, 97155 and 97156 are payable under…
Arkansas Blue Cross and Blue Shield	See guide	See guide
Aetna in Arkansas	Required: all ten ABA codes, 97151 included, are on Aetna’s behavioral health precertification list	See guide
Cigna / Evernorth in Arkansas	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	Required: complete the assessment and treatment plan, then the Applied Behavior Analysis Prior Authorization…
UnitedHealthcare / Optum in Arkansas	Required: “Prior authorization is required for ABA *(unless otherwise specified or mandated by contract or…	See guide

Payer	Assessment (97151)	Treatment
Rhode Island Medicaid	Fee-for-service: no separate assessment PA code	Fee-for-service: yes
Neighborhood Health Plan of Rhode Island	See guide	See guide
UnitedHealthcare Community Plan of Rhode Island	See guide	See guide
Tufts Health RITogether (Tufts Health Public Plans)	No	No
Aetna in Rhode Island	Required: all ten ABA codes, 97151 included, are on Aetna’s behavioral health precertification list	See guide
Cigna / Evernorth in Rhode Island	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	Required: completed assessment and treatment plan attached to the Applied Behavior Analysis Prior…
UnitedHealthcare / Optum in Rhode Island	Required: the ABA Supplemental Clinical Criteria require prior authorization for ABA "unless otherwise…	See guide
Blue Cross & Blue Shield of Rhode Island	See guide	See guide

Payer	Assessment (97151)	Treatment
Wyoming Medicaid	No up-front prior authorization: the 10/01/2026 fee schedule’s PRIOR_AUTH column is blank for 97151 and every…	Not up front, but in practice yes: 97151–97158 are inside the 30-visit-per-year behavioral-health threshold,…
Blue Cross Blue Shield of Wyoming	See guide	Yes: medical policy 15.01.002 lists the guidelines that "must be met" to "determine the appropriate initial…
Aetna in Wyoming	Required: all ten ABA codes, 97151 included, are on Aetna’s behavioral health precertification list	See guide
Cigna / Evernorth in Wyoming	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	Required: completed assessment and treatment plan on the Applied Behavior Analysis Prior Authorization Form
UnitedHealthcare / Optum in Wyoming	Required: the ABA Supplemental Clinical Criteria say "Prior authorization is required for ABA" unless…	See guide

Payer	Assessment (97151)	Treatment
West Virginia Medicaid (BMS)	Required	Yes for every ABA code (97152–97156, 97158)
Aetna Better Health of West Virginia	See guide	Required
The Health Plan of West Virginia (Mountain Health Trust)	See guide	See guide
Highmark Health Options West Virginia (Mountain Health Trust)	See guide	Required
Wellpoint West Virginia (Mountain Health Trust)	See guide	See guide
Aetna in West Virginia	Required: all ten ABA codes, 97151 included, are on Aetna’s behavioral health precertification list	See guide
Cigna / Evernorth in West Virginia	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	Required: the completed assessment and treatment plan go with the ABA Prior Authorization Form
UnitedHealthcare / Optum in West Virginia	Required: the ABA Supplemental Clinical Criteria require prior authorization for ABA "unless otherwise…	See guide
Highmark Blue Cross Blue Shield West Virginia	Yes: 97151, 97152 and 0362T are on Highmark’s List of Procedures Requiring Authorization (effective…	Yes: 97153–97158 and 0373T are on the same list

Payer	Assessment (97151)	Treatment
District of Columbia Medicaid	See guide	Required
AmeriHealth Caritas District of Columbia	Required	Yes for 97153 and 97155 (and 0373T, flagged not on the DC Medicaid fee schedule)
MedStar Family Choice District of Columbia	See guide	Required
Health Services for Children with Special Needs (HSCSN)	No, within limits	Required
Aetna in the District of Columbia	Required: all ten ABA codes, 97151 included, are on Aetna’s behavioral health precertification list	See guide
Cigna / Evernorth in the District of Columbia	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	Required: after the assessment, submit the treatment plan on the Applied Behavior Analysis Prior…
UnitedHealthcare / Optum in the District of Columbia	Required: Optum’s ABA Supplemental Clinical Criteria say "Prior authorization is required for ABA" unless…	See guide
CareFirst BlueCross BlueShield (District of Columbia)	See guide	Required

Payer	Assessment (97151)	Treatment
Mississippi Medicaid	Fee-for-service: no for 97151 (the PA column is blank on the July 2026 ASD fee schedule and 97151 is not on…	Fee-for-service: yes
Magnolia Health (MississippiCAN / CHIP)	Not for 97151: Magnolia’s CMS 0057-F PA list names 0362T, 0373T and 97152–97158 under Applied Behavioral…	Required for 97153–97158 and 0373T
Molina Healthcare of Mississippi (MississippiCAN / CHIP)	See guide	Required: "Applied Behavioral Analysis (ABA) – for treatment of Autism Spectrum Disorder (ASD)" is on…
TrueCare (MississippiCAN / CHIP)	No for 97151: TrueCare’s Procedure Code Lookup Tool (Mississippi Medicaid, outpatient) returns "Auth is…	Yes: TrueCare’s Procedure Code Lookup Tool (Mississippi Medicaid, outpatient, any place of service) returns…
Aetna in Mississippi	Required: all ten ABA codes, 97151 included, are on Aetna’s behavioral health precertification list	See guide
Cigna / Evernorth in Mississippi	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	Required: after the assessment, submit the Applied Behavior Analysis Prior Authorization Form with the…
UnitedHealthcare / Optum in Mississippi	Required: Optum’s ABA Supplemental Clinical Criteria require prior authorization for ABA "unless otherwise…	See guide
Blue Cross & Blue Shield of Mississippi	No prior authorization since 8/1/2024 for fully insured, self-funded group and State Health Plan members	No: "submission of the individualized ABA treatment plan for approval by the Company is no longer required"…

Aetna · US · 9 rules

Read the full guide →

Prior authorization

What Aetna requires for precertification

The current revision of form GR-69017-4 is stamped 7-26 and states: "Effective August 1, 2026, this form replaces all other Applied Behavior Health Analysis (ABA) precertification information request documents and forms." The form does not start a request. You initiate on Availity (Authorization/Precertification Add, then a short questionnaire if asked) or by calling the… full guide →

Payer	Assessment (97151)	Treatment
Delaware Medicaid (DMAP / Diamond State Health Plan)	See guide	See guide
AmeriHealth Caritas Delaware	Required	Required for every ABA code
Highmark Health Options	Required	Yes: precertification for all outpatient behavioral health, faxed on the Request for Authorization form or…
Delaware First Health	Required	Required
Highmark Blue Cross Blue Shield Delaware	Yes: 97151, 97152 and 0362T are on Highmark’s authorization list (effective 10/01/2026, "For PA, WV, DE & NY…	Yes: 97153–97158 and 0373T (plus H0032 and H2019 under the same ABA category) are on the list, managed by…
Aetna in Delaware	Required: all ten ABA codes, 97151 included, are on Aetna’s behavioral health precertification list	Required: precertification through Availity or the number on the card
Cigna / Evernorth in Delaware	Not required for 97151, 97152 and 0362T with an autism diagnosis when the provider is independently licensed…	Required: completed assessment and treatment plan with the ABA Prior Authorization Form
UnitedHealthcare / Optum in Delaware	Required: Optum’s ABA criteria require prior authorization for ABA "unless otherwise specified or mandated by…	Required

Payer	Assessment (97151)	Treatment
Aetna	Required	Required
Cigna / Evernorth	Not required for assessment codes 97151, 97152, 0362T (with ASD dx + licensed/BCBA provider)	Required
UnitedHealthcare / Optum	Required	Required
Meritain Health	See guide	See guide
ASR Health Benefits	See guide	See guide
Humana	See guide	See guide
Carelon Behavioral Health	Required	Required
Magellan Health / Magellan Healthcare	Required	Required
ComPsych	See guide	See guide
TRICARE East (Humana Military)	Required	Required
TRICARE West (TriWest)	Required	Required
CHAMPVA	Not required	Required

Every ABA payer policy, in one place.

Payer guides, by state

Georgia Medicaid

CareSource (Georgia Medicaid CMO)

Peach State Health Plan (GA Medicaid CMO)

Amerigroup (GA Medicaid CMO)

Anthem BCBS Georgia

Aetna in Georgia

Cigna / Evernorth in Georgia

UnitedHealthcare / Optum in Georgia

North Carolina Medicaid

Healthy Blue (NC)

AmeriHealth Caritas North Carolina

Carolina Complete Health

UnitedHealthcare Community Plan of North Carolina

WellCare of North Carolina

Alliance Health (NC Tailored Plan)

Trillium Health Resources (NC Tailored Plan)

Vaya Health (NC Tailored Plan)

Partners Health Management (NC Tailored Plan)

Aetna in North Carolina

Cigna / Evernorth in North Carolina

UnitedHealthcare / Optum in North Carolina

MedCost Benefit Services

Blue Cross Blue Shield of North Carolina

Indiana Medicaid (IHCP)

Anthem BCBS Indiana (Medicaid)

MHS — Managed Health Services (Indiana)

CareSource Indiana

MDwise (Indiana)

UnitedHealthcare Community Plan of Indiana

Aetna in Indiana

Cigna / Evernorth in Indiana

UnitedHealthcare / Optum in Indiana

Anthem BCBS Indiana

Anthem Blue Cross and Blue Shield Indiana (commercial)

CareSource Indiana Marketplace

Virginia Medicaid (DMAS)

Aetna Better Health of Virginia

Anthem HealthKeepers Plus (VA)

Humana Healthy Horizons in Virginia

Sentara Community Plan (VA)

UnitedHealthcare Community Plan of Virginia

Aetna in Virginia

Cigna / Evernorth in Virginia

UnitedHealthcare / Optum in Virginia

Anthem BCBS Virginia

TennCare (Tennessee Medicaid)

BlueCare Tennessee (BCBST)

UnitedHealthcare Community Plan of Tennessee

Wellpoint Tennessee (formerly Amerigroup)

TennCare Select

Aetna in Tennessee

Cigna / Evernorth in Tennessee

UnitedHealthcare / Optum in Tennessee

Blue Cross Blue Shield Tennessee

Ohio Medicaid

CareSource Ohio

Buckeye Health Plan (OH)

Molina Healthcare of Ohio

Anthem BCBS Ohio (Medicaid)

UnitedHealthcare Community Plan of Ohio

AmeriHealth Caritas Ohio

Humana Healthy Horizons in Ohio

Aetna in Ohio

Cigna / Evernorth in Ohio

UnitedHealthcare / Optum in Ohio

Anthem BCBS Ohio

NJ FamilyCare (New Jersey Medicaid)

Horizon NJ Health

Aetna Better Health of New Jersey

Fidelis Care New Jersey (formerly WellCare)

UnitedHealthcare Community Plan (NJ FamilyCare)

Wellpoint New Jersey (formerly Amerigroup)

Aetna in New Jersey

Cigna / Evernorth in New Jersey

UnitedHealthcare / Optum in New Jersey

Horizon Blue Cross Blue Shield of New Jersey

Maryland Medicaid (Medical Assistance)

Johns Hopkins US Family Health Plan