---
title: "Louisiana Healthcare Connections ABA coverage: the intake guide."
url: "https://carelu.com/payers/louisiana-healthcare-connections"
markdown_url: "https://carelu.com/payers/louisiana-healthcare-connections.md"
state: LA (Louisiana)
payer: Louisiana Healthcare Connections
kind: Medicaid managed care plan (MCO)
parent_program: Louisiana Medicaid (Healthy Louisiana)
description: "How Louisiana Healthcare Connections covers ABA for Medicaid members under 21: LA.UM.49 and the LDH manual, the uniform ABA authorization form, the end of Magellan review, COB pending rules, and turnaround."
last_reviewed: October 2026
---

# Louisiana Healthcare Connections ABA coverage: the intake guide.

_Payer Guide · Louisiana Healthcare Connections · Last updated October 2026 · 9 primary sources_

> Centene’s Healthy Louisiana plan: ABA reviewed in-house (formerly Magellan) under LA.UM.49; uniform ABA form via portal or fax.

Louisiana Healthcare Connections (LHCC, a Centene plan) is one of the four Healthy Louisiana plans continuing into 2027. Its ABA policy, LA.UM.49, says simply that LHCC "will follow the guidelines published in the Louisiana Department of Health (LDH) Applied Behavior Analysis Provider Manual," and attaches it. ABA reviews used to run through Magellan; LHCC’s November 2025 notice says the process "may differ from what you experienced previously with Magellan," and the uniform ABA form now goes to LHCC’s own ABA department.

This plan administers the **Louisiana Medicaid (Healthy Louisiana)** ABA benefit: the state rules are the floor, and this page covers what the plan layers on top. Read it together with the [Louisiana Medicaid (Healthy Louisiana) guide](https://carelu.com/payers/louisiana-medicaid).

## Prior authorization and diagnosis at a glance

- **Prior auth for the assessment**: Yes. LA.UM.49: the behavior identification assessment "must be prior authorized by LHCC," as must the supporting assessments; the initial assessment is authorized once, for up to 180 days [1]
- **Prior auth for treatment**: Yes. Submit the uniform ABA authorization form with the CDE and treatment plan through the provider portal (preferred) or fax 1-888-725-0101 to LHCC’s Applied Behavioral Analysis Department [3][1]
- **Autism diagnosis required?**: A qualifying diagnosis after a CDE: LHCC "will follow the guidelines published in the" LDH ABA manual, which covers conditions ABA is recognized to treat, including ASD [1][5]

## At a glance

- **Covers ABA?:** Yes, members under 21 with a qualifying CDE
- **Prior auth:** Assessment (once, initial) and treatment; 180-day maximum
- **Submit via:** Provider portal (preferred) or fax 1-888-725-0101
- **Decision clock:** Most routine requests in 2 business days; up to 7 calendar days
- **Other insurance:** Authorization pends until the primary insurer’s decision is received
- **Contact:** Provider Services 1-866-595-8133

## Prior authorization and the uniform form

LA.UM.49 adopts the LDH manual’s coverage, CDE, treatment-plan and supervision rules. It treats the assessment slightly more tightly than the current manual: "This is for the initial assessment only. The initial assessment will be authorized only once," for up to 180 days, with extra assessments at the plan’s discretion. LHCC’s November 17, 2025 notice introduced the uniform ABA Prior Authorization Form built with the other plans. Its checklist for an initial treatment request includes the CDE, a treatment plan with measurable goals and parent training, the proposed schedule with provider types, a dated IEP or IFSP, waiver pages, objective testing, coordination with other providers, and individualized titration and discharge plans; continued requests add objective progress data. Submit it through the provider portal or by fax to 1-888-725-0101. [1][2][3]

## Other insurance and turnaround

The November 2025 notice changed how LHCC handles children with commercial coverage: "Historically, ABA authorizations were administratively approved even when a member had a primary payor. Moving forward, we will follow the standard Coordination of Benefits (COB) process." If the primary covers ABA, "the authorization will be placed in a pending status until primary coverage is confirmed," so send the primary insurer’s approval or denial with the request. LHCC asks for standard requests "at least seven business days before the scheduled service delivery date," processes most routine authorizations "within two business days," and says requests needing more information or medical director review may take "up to 7 calendar days." [2][4]

## Intake gates

The questions that decide whether a family can start with Louisiana Healthcare Connections, and what they have to bring.

- **Age limit**: Under 21: LA.UM.49 notes LDH covers ABA "for recipients under the age of 21." [1]
- **Diagnosis recency**: LHCC follows the LDH manual. No expiry. "MCOs shall not deny services based solely on the age of the CDE," and "The CDE only needs to be included in the first PA request per member per provider." The MCO "shall deny service if no CDE exists," and if it asks for a new CDE it "shall not deny or delay available ABA services while waiting for a CDE." A family that switches ABA providers needs the CDE sent again with the new provider’s first request. [1][5]
- **Who may diagnose**: LA.UM.49’s own QHCP list is the older version: pediatric neurologist, developmental pediatrician, psychologist or medical psychologist, psychiatrist, or another licensed individual approved by the plan’s medical director with ASD diagnostic scope and two years’ experience. The current LDH manual, which the policy says it follows, adds pediatricians using the MCHAT-R/F, team-based pediatricians and supervised nurse practitioners. [1][5]
- **Diagnostic tools required**: No instrument is required for the diagnosis, but the uniform form asks initial assessment requests for "comprehensive diagnostic information including standardized measures" and initial treatment requests for "Objective testing showing significant behavioral deficit" and the functional assessment tool used, with baseline data. [3][1]
- **Referral required?**: The uniform form asks for the CDE and a "Prescription for ABA ordered by a QHCP if ABA is not recommended in CDE," plus a referral from the diagnosing provider with estimated duration of care for an initial assessment. LHCC otherwise requires no paper referral to in-network specialists. [3][4]
- **Telehealth**: LHCC publishes no ABA telehealth rule of its own and follows the LDH manual. Yes, with prior authorization. The LDH manual lists 97151–97158 as codes that "can be performed via telehealth," with reimbursement rules otherwise unchanged; services must be "rendered or directed by a RLT, LBA, or CaBA" over "an interactive audio/visual telecommunications system." Reassessments and treatment plans may be done remotely "only if the same standard of care can be met," and RLT supervision "may be conducted via telehealth in lieu of the LBA/CaBA being physically present." 0362T and 0373T are not on the telehealth list. "Telehealth requires PA for services," and approved PAs can be amended to add units or reflect reassessment goals. The chapter names no telehealth place-of-service code or modifier, so each MCO’s billing rules decide those. [1][5]
- **Prior-auth decision time**: Submit standard requests at least 7 business days before services start; most routine authorizations are processed within 2 business days, and those needing more information or medical director review within 7 calendar days. That matches the federal 7-day cap for rating periods from January 1, 2026. [4][7]
- **Other insurance (who pays first)**: Since November 2025: "If a member’s primary insurance covers ABA services, Medicaid will remain the payor of last resort, and the authorization will be placed in a pending status until primary coverage is confirmed." Send the primary insurer’s determination (approval or denial) with the request. [2][8]

## Delivery and billing rules

Coverage decides whether Louisiana Healthcare Connections pays. These decide whether the claim survives: staffing and supervision, concurrent billing, per-day ceilings, who signs the note, where the service is payable, and whose NPI the claim goes out under.

- **Supervision**: LA.UM.49 follows and attaches the LDH manual, whose ratio applies. Louisiana Medicaid sets the ratio in the ABA manual chapter: supervision "shall be approved on a 2:10 basis; that is two hours of supervision for every ten hours of therapy," part of it "must be done in the presence of the beneficiary" and the CaBA or registered line technician (RLT), and it "will not be approved if the licensed supervising professional is delivering the direct therapy." The licensed supervising professional "shall supervise no more than 24 technicians a day" (more if a CaBA is on the team) and "no more than 10 CaBAs." If technician services are in the plan, supervision by a licensed behavior analyst must be part of it. [1][5]
- **Concurrent billing (97153 + 97155)**: LHCC follows the LDH manual, which allows it. Yes. The LDH manual says: "One-on-one supervision may by be conducted and billed simultaneously and concurrently with one-on-one therapeutic behavioral services. Supervision can only occur when a non-licensed professional is providing the therapeutic behavioral services." In practice that is 97155 alongside 97153 when an RLT or CaBA is delivering the session. [1][5]
- **Session-note signature**: LHCC follows the LDH manual. Start and stop times are required "for every code billed" (at the start of the session, after any break of 12 minutes or more, and on a switch of billing code). "The person delivering the service must sign, date, and include their credentials in the documentation for each day and distinct session," and the daily log must also carry the "Name, signature, and credentials for supervising BCBA who is also rendering provider for billing." For an RLT session, recorded data can replace the narrative. Records are kept at least six years. [1][5]
- **Place of service**: LA.UM.49: services "must be provided in a natural setting (e.g., home and community-based settings, including clinics and school)," and school-based ABA is allowed. LA.UM.49 says nothing about ABA overlapping another therapy, so the LDH manual governs that and adds the IEP requirement for school plans and the non-ABA-facility addendum. Services "must be provided in a natural setting (e.g., home and community-based settings, including clinics and school)," and school-based ABA by ABA providers is allowed. A treatment plan that puts services in a school "will not be approved until an IEP is provided" to the MCO. Sessions at a "non-ABA facility" (any place other than the home that does not offer ABA as a primary service) need an addendum explaining why they cannot happen at home or at the ABA facility. A change of setting mid-authorization needs a treatment-plan addendum. Overlap with other therapies (speech, OT, PT, waiver services): ABA may be delivered "simultaneously with another service, if allowed per medically unlikely edits and coding guidelines," only when "the other service in question must not have a restriction that keeps it from being performed at the same time as another service," and the treatment-plan addendum must give the frequency and duration of sessions when the ABA provider and the other provider are both present and what the other provider needs to implement the skill. [1][5]
- **Bill as provider**: LA.UM.49: "Payment for services must be billed by the licensed professional." The uniform form is signed by the rendering provider, who attests that all staff have the required training. The LDH manual adds that the rendering provider on the claim must be the supervisor who signed the documentation. [1][3][5]
- **Daily limits / MUEs** _(plan-dependent)_: No unit cap is published; LHCC’s form requests units per week and in total for each code, and authorizations run no more than 180 days. [3][1]
  - Ask the plan: LHCC Provider Services, 1-866-595-8133: ask how weekly and total units are enforced on claims.

## What intake should collect for Louisiana Healthcare Connections

- **Member ID:** Confirm Louisiana Healthcare Connections on the date of service.
- **Comprehensive diagnostic evaluation:** From a QHCP; the uniform form also asks for a referral from the diagnosing provider with estimated duration of care.
- **IEP or IFSP:** Dated copy, if the child has one; the form asks whether services happen at school.
- **Primary insurer decision:** Required when the child has other coverage; without it the authorization stays pending.

Free verification-call checklist (PDF): https://carelu.com/downloads/aba-verification-call-checklist.pdf

## Common questions

### Does Louisiana Healthcare Connections still use Magellan for ABA?

Its November 2025 notice moved ABA requests to a uniform form sent to LHCC’s own ABA department and warns the process may differ from what providers knew under Magellan.

### Why is my LHCC ABA authorization pending?

If the child has other insurance that covers ABA, LHCC holds the authorization until you send the primary insurer’s approval or denial. Medicaid pays last.

### How far ahead should I request ABA from LHCC?

At least 7 business days before services start. Most routine requests are processed within 2 business days; complex ones can take up to 7 calendar days.

## Primary sources

1. [Louisiana Healthcare Connections — LA.UM.49, Outpatient Applied Behavior Analysis Medical Necessity Criteria](https://www.louisianahealthconnect.com/content/dam/centene/louisiana-health-connect/policies/clinical-policies/LA.UM.49_Outpatient_Applied_Behavior_Analysis_Medical_Necessity_Criteria.pdf)
2. [Louisiana Healthcare Connections — Uniform ABA Prior Authorization Form Now Available (11/17/25)](https://www.louisianahealthconnect.com/newsroom/uniform-aba-prior-authorization-form-now-available.html)
3. [Uniform (all-MCO) Applied Behavioral Analysis Authorization form, Louisiana Healthcare Connections copy (11/2025)](https://www.louisianahealthconnect.com/content/dam/centene/louisiana-health-connect/pdfs/medicaid-provider/LHCC%20ALL%20MCO%20ABA%20AUTH%20FORM%20112025.pdf)
4. [Louisiana Healthcare Connections — Prior Authorization (provider resources)](https://louisianahealthconnect.com/providers/resources/prior-authorization.html)
5. [LDH Medicaid Services Manual, Chapter 4: Applied Behavior Analysis (issued 08/22/25)](https://www.lamedicaid.com/provweb1/Providermanuals/manuals/ABA/ABA.pdf)
6. [Louisiana Medicaid Applied Behavioral Analysis Fee Schedule (dates of service on or after July 1, 2022)](https://www.lamedicaid.com/provweb1/fee_schedules/ABA_FS_Current.pdf)
7. [42 CFR 438.210(d) — Medicaid managed care authorization timeframes (eCFR)](https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-C/part-438/subpart-D/section-438.210)
8. [42 CFR 433.139 — Medicaid third-party liability (eCFR)](https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-C/part-433/subpart-D/section-433.139)
9. [Louisiana Healthcare Connections — Newsroom (provider notices archive)](https://www.louisianahealthconnect.com/newsroom.html)

Payer policies change frequently and vary by plan, state, and funding type. This guide was compiled from the sources above and last reviewed October 2026; it is general information, not billing, legal, or clinical advice. Always verify current requirements against the payer's live policy and a benefits check for the specific member.

Source: Carelu ABA Payer Directory — https://carelu.com/payers. Free to cite with attribution.