---
title: "North Dakota Medicaid ABA coverage: the intake guide."
url: "https://carelu.com/payers/north-dakota-medicaid"
markdown_url: "https://carelu.com/payers/north-dakota-medicaid.md"
state: ND (North Dakota)
payer: North Dakota Medicaid
kind: State Medicaid program
description: "How North Dakota Medicaid covers ABA: a fee-for-service benefit for members under 21 with autism, the prior approval letter and twice-yearly service authorizations, the 2026 rates, telehealth, timely filing, the Autism waiver, and behavior-analyst licensure."
last_reviewed: October 2026
---

# North Dakota Medicaid ABA coverage: the intake guide.

_Payer Guide · North Dakota Medicaid · Last updated October 2026 · 28 primary sources_

> ABA is a fee-for-service state plan benefit through age 20: a prior approval letter, then web service authorizations twice a year; rates published.

North Dakota Medicaid covers applied behavior analysis for members under 21 with an autism spectrum disorder diagnosis. It is a fee-for-service benefit run by the Medical Services Division: there is no managed care plan between the family and the state for ABA. Medicaid Expansion is administered by Blue Cross Blue Shield of North Dakota, but Expansion members aged 19 and 20 are enrolled in traditional Medicaid, and the ABA codes are "Covered through age 20 only," so the Expansion plan never carries an ABA benefit.

The front door is unusual. Before any provider is involved, the family sends the department a Health Tracks (EPSDT) screening that lists the autism diagnosis and recommends ABA; the department answers with a prior approval letter the family takes to the provider of its choice. The provider then requests a service authorization twice a year with the care plan. Behavior analysts must hold a North Dakota license, and every enrolled clinician, technicians included, bills under their own NPI.

## Prior authorization and diagnosis at a glance

- **Prior auth for the assessment**: Yes. The child first needs ND Medicaid’s annual prior approval letter, and the August 2026 fee schedule flags 97151 and 97152 "Service Authorization Required: Yes" [1][5]
- **Prior auth for treatment**: Yes. The agency submits a web-based service authorization twice a year (annual and 180-day update) with the care plan and the yearly approval letter attached; every covered ABA code (97151–97156, 0373T) is flagged SA "Yes" [1][5][9]
- **Autism diagnosis required?**: Yes. An autism spectrum disorder diagnosis "from their primary care provider (PCP) or licensed medical care provider qualified to diagnose autism spectrum disorder," plus an annual Health Tracks (EPSDT) screening recommending ABA [1]

## At a glance

- **Covers ABA?:** Yes, for members under 21 with an autism spectrum disorder diagnosis
- **Structure:** Fee-for-service only; the Medicaid Expansion MCO (BCBSND) serves adults 21+ and carries no ABA
- **Front door:** Annual Health Tracks screening recommending ABA → department prior approval letter
- **Prior auth:** Web-based service authorization at the annual and 180-day update; all ABA codes SA "Yes"
- **Rates (Aug. 2026, per unit):** 97151/97155 $31.76 · 97152 $23.51 · 97153 $10.81 · 97154 $2.72 · 97156 $29.48 · 0373T $12.99
- **Not covered:** 97157, 97158 and 0362T
- **Licensure:** Yes: licensed behavior analyst / assistant under N.D.C.C. ch. 43-64 (Board of Integrative Health Care)
- **Timely filing:** 180 days from date of service (365 for claims with other insurance)

## Where ABA sits: a fee-for-service benefit through age 20

ND Medicaid’s ABA policy describes the service as "assistance provided to a qualifying individual with an autism spectrum disorder (ASD) diagnosis," made up of service oversight (comprehensive assessment, care plan development, referral, monitoring and follow-up) and skills training for the child and caregivers, delivered "within the home, community, or a provider’s facility." The child must be under 21, Medicaid eligible on the dates of service, have an ASD diagnosis, and have a current Health Tracks screening. The Medicaid Covered Services chapter lists the Autism Spectrum Disorder ABA Service with a service authorization "annually, and a 180-day update" and an age limit: "must be under 21 years of age." The professional fee schedule marks each ABA code "Covered through age 20 only" and "only billable by providers that are enrolled to provide ABA services to children diagnosed with Autism Spectrum Disorder." [1][3][5][19][27]

There is no MCO to route through. The member eligibility chapter (July 2026) says Medicaid Expansion covers adults 19 to 64 through Blue Cross Blue Shield of North Dakota, but "Enrollees 19-20 years old are eligible for Medicaid Expansion based on income but are enrolled in traditional Medicaid." Since ABA stops at age 20, every ND Medicaid ABA claim goes to the state. The BCBSND Medicaid Expansion provider manual mentions ABA only in a form title marked "FEP only." [1][3][5][19][27]

## The front door: Health Tracks screening and the prior approval letter

The family, not the provider, opens the case. The child needs "an annual North Dakota Health Tracks (EPSDT) screening completed at a public health unit or by a PCP," current "within six months of the date considered eligible for the service," and "Comments in the recommendation portion of that screening must support and recommend Autism ABA services." Children who meet the criteria "will receive a letter of approval from ND Medicaid to take to their provider." Approval runs for "a twelve-month period; annual review of medical necessity is required," and the screening for the renewal "can be completed within 6 months prior to due date." HHS’s Children’s Waiver Services page describes the same steps in plain language (a Medicaid wellness visit within six months documenting the diagnosis and a recommendation for ABA). HHS’s page lists dhsautism@nd.gov for questions; the Service Authorizations chapter lists dhsserviceauth@nd.gov for general service authorization questions and (701) 328-7068 for behavioral health authorizations. [1][2][9]

## Service authorization, the care plan and the 180-day update

Once the family has the letter, the "Agency/ School will submit a web-based Service Authorization request twice per year (annual and 180-day update)," with "The care plan and yearly letter of approval" attached. The February 2025 policy requires an evidence-based functional assessment with indirect and direct measures "(VB-MAPP or ABLLS-R)," target behaviors that "should not be vocational or educational in purpose," baseline measurements and "Graphs on starting point and progress of data," measurable goals that can be met in the authorization period, caregiver training goals, the location, and the "Number of hours of Autism ABA service per week / per service code" with "justification of units requested" and the "Majority requested provided by an RBT." Reassessment at 180 days updates the targets, goals, "Description of improvements" and hours, and progress monitoring expects that "Graphs should be easily readable" with "Standardized data collection protocols." Punishment procedures "will in most cases be denied." The policy expects data reviewed often enough that changes are made "in a timely manner" (defined as "4-6 weeks no improvement") and monthly meetings between the skills trainer and the caregiver. Services paid without a required authorization "are subject to recoupment"; a retroactive request may be considered "up to 90 days after the initial date of service with good cause." [1][9]

## Who may deliver ABA, and how they enroll

Service oversight must be done by "a licensed board-certified behavior analyst (BCBA)," a licensed BCBA-D, a "registered behavior analyst," or a "licensed clinical psychologist." Skills trainers may be an RBT, a board certified autism technician (BCAT), a registered behavior analyst, a BCaBA, BCBA or BCBA-D, or a licensed social worker (LBSW, LMSW, LCSW), LPCC, LMFT, speech-language pathologist, occupational therapist or physical therapist. People with a bachelor’s or master’s in a listed field (social work, psychology, special education, applied behavioral sciences and others) "may enroll to provide skills training; however, they must become a registered behavior technician or board certified autism technician within six months of enrollment." Skills training "must be supervised by a practitioner qualified to provide Service Oversight, operating within North Dakota scope of practice laws." Public schools may enroll to provide ABA through the IEP, but school services "must still have a care plan written by Board Certified Behavior Analyst (BCBA)." [1][10][11][5][12]

Enrollment is per person. "All eligible providers must enroll and bill with their own NPI. Providers eligible to enroll may not bill for services under a supervising or peer provider’s NPI," and the servicing provider’s NPI must be enrolled on the date of service. ABA claims go on a CMS 1500 or 837P ("Applied Behavioral Analyst" is a listed professional provider type), and the fee schedule shows no ordering/referring/prescribing (ORP) NPI requirement on the ABA codes. The Behavioral Health Rehabilitative Services chapter lists "Behavior Analyst" with licensure through the Board of Integrative Health Care and lets behavior analysts bill ABA codes for youth with autism in addition to the rehab codes. [1][10][11][5][12]

## What does North Dakota Medicaid pay for ABA?

ABA rates now sit in the Autism category of the professional fee schedule (data updated August 1, 2026), per unit: 97151 $31.76, 97152 $23.51, 97153 $10.81, 97154 $2.72, 97155 $31.76, 97156 $29.48 and 0373T $12.99. 97157, 97158 and 0362T are listed as not covered. Each covered ABA line is marked telehealth allowed, service authorization required, no ORP NPI required, and EVV "No." For comparison, the archived Autism Services Fee Schedule as of 7/1/2025 paid 97151 and 97155 $31.14, 97152 $23.05, 97153 $10.60, 97154 $2.67, 97156 $28.90 and 0373T $12.74, so the 2026 lines are about 2% higher. The schedule itself warns that inclusion "does not imply Medicaid coverage," so read it with the ABA policy. [5][6][7]

## Claims operations: timely filing, telehealth, EVV and appeals

Timely filing: "ND Medicaid must receive an original Medicaid primary claim within one hundred eighty (180) days from the date of service." A claim with third-party payment has 365 days from the date of service, as do replacements, resubmissions and voids of a timely original. Retroactive member eligibility gives 180 days from the eligibility determination. A provider may ask for review of a payment denial "within thirty (30) days of the date of the department’s denial of payment." [16][5][15][18][9]

Telehealth: the fee schedule marks every covered ABA code telehealth-allowed. The telehealth chapter (October 2025) requires the same standard of care as in person on a HIPAA-compliant platform, POS 02 (not the home) or POS 10 (the patient’s home), modifier 93 when audio-only, and audio-only only for codes the Procedure Code Look-up Tool allows. Both sites must document where the member and provider were. EVV: the EVV chapter applies to personal care, home health, 1915(i) and waiver respite and in-home supports (including the Autism waiver), and the fee schedule lists EVV "No" for the ABA codes. [16][5][15][18][9]

Service authorization denials: the member may ask for reconsideration through the provider "Within 30 days of a denied service authorization," or request a hearing from the Legal Advisory Unit within 30 days of the denial. Providers may resubmit with new records at any time. [16][5][15][18][9]

## Licensure and out-of-state BCBAs

North Dakota licenses behavior analysts under N.D.C.C. chapter 43-64: since January 1, 2020 "an individual may not practice applied behavior analysis without a current license issued by the board," the State Board of Integrative Health Care, which the BACB’s licensure table also lists. Medicaid enrollment requires "a valid license, certification, accreditation, or registration according to the state laws and regulations of the state in which services are rendered." A BCBA licensed elsewhere can seek a North Dakota license by endorsement; we found no exemption in the statute or rules for an out-of-state analyst treating a North Dakota child by telehealth. Separately, ND Medicaid treats providers more than 50 miles from the border as out-of-state: "Out-of-state services require a service authorization except when services provided are in response to an emergency," and out-of-state providers file an Out of State/Out of Network Enrollment Clarification Form (SFN 509). [22][23][24][10][20]

## The Autism Spectrum Disorder waiver is not ABA

North Dakota also runs a 1915(c) Autism Spectrum Disorder waiver (ND.0842). Its November 1, 2025 amendment raised the age limit to "Through the age of 20," allowing participants "to remain on the waiver until their 21st birthday," and changed maximum enrollment "to 400 per year with 345 active." HHS lists its services as assistive technology, community connector, remote monitoring, service management and respite care; ABA is not one of them. The waiver runs alongside the state plan ABA benefit, and its respite and in-home support providers are subject to EVV. Two ND Medicaid chapters (member eligibility, July 2026; EVV) still call it the "Birth through age 17" or "Birth through Seventeen" waiver, so expect older wording on forms. [21][2][18][19]

## Intake gates

The questions that decide whether a family can start with North Dakota Medicaid, and what they have to bring.

- **Age limit**: Under 21. The child must "Be under 21 years of age," and the fee schedule marks each ABA code "Covered through age 20 only." [1][5][3]
- **Diagnosis recency**: No recency rule on the diagnosis itself. The dated requirement is the Health Tracks (EPSDT) screening: current "within six months of the date considered eligible," repeated every 12 months for a new approval letter (the renewal screening may be done up to six months early). [1][2]
- **Who may diagnose**: The child’s "primary care provider (PCP) or licensed medical care provider qualified to diagnose autism spectrum disorder." [1]
- **Diagnostic tools required**: No diagnostic instrument is named. For the ABA assessment, the February 2025 policy requires an evidence-based functional assessment with indirect and direct measures "(VB-MAPP or ABLLS-R)" and baseline data with graphs. [1]
- **Referral required?**: Yes, in effect, and the order comes from a well-child visit. The family completes a Medicaid wellness visit (Health Tracks/EPSDT screening) with the primary care provider or a public health unit within six months of approval; its recommendation section must "support and recommend Autism ABA services," and HHS asks that the documentation state the autism diagnosis and a "Recommendation stating the individual will benefit from ABA Services." The screening goes to ND Medicaid with the packet, and the department issues a prior approval letter that can be shared "with the provider of their choice." Approval runs twelve months: a new wellness visit (which "can be completed within 6 months prior to due date") is needed for each year’s letter, and the letter must be attached to each service authorization. No separate order form is published. [1][2]
- **Telehealth**: Yes. The August 2026 fee schedule marks 97151, 97152, 97153, 97154, 97155, 97156 and 0373T "Telehealth Allowed: Yes." The telehealth chapter requires the same standard of care as in person on a HIPAA-compliant platform, POS 10 when the child is home and POS 02 elsewhere, modifier 93 for audio-only, and audio-only only when the Procedure Code Look-up Tool allows it for the code. Both sites document the member’s and provider’s physical locations. The clinician must be enrolled and licensed where the service is rendered. [5][15][10]
- **Prior-auth decision time**: ND Medicaid publishes no ABA decision clock. The federal fee-for-service floor applies: since January 1, 2026 the state agency must decide a standard request "in no case later than 7 calendar days after receiving the request" and an expedited one "in no case later than 72 hours." Incomplete submissions "will be returned or denied," and retroactive requests are possible "up to 90 days after the initial date of service with good cause." [25][9]
- **Other insurance (who pays first)**: "North Dakota Medicaid is generally the payer of last resort." Providers must identify other coverage before billing, follow the other payer’s rules, and send its EOB with the claim; Medicaid pays "the amount designated as the member responsibility up to the Medicaid allowed amount," or $0 if the other payer paid more. The TPL chapter lists exceptions where a provider "may submit claims directly to ND Medicaid even if there is a liable third party," including "Services provided for Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)"; the Autism waiver exception expressly "does not include applied behavioral analysis services," and the chapter does not say whether ABA counts as an EPSDT service for this purpose. Secondary claims have 365 days from the date of service. [17][16][26]

## Delivery and billing rules

Coverage decides whether North Dakota Medicaid 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**: No numeric ratio is published. Skills training "must be supervised by a practitioner qualified to provide Service Oversight" (a licensed BCBA or BCBA-D, a registered behavior analyst, or a licensed clinical psychologist) "operating within North Dakota scope of practice laws." Skills training must include "meeting with the Service Oversight practitioner and the caregiver at least monthly" to review progress and the care plan, and the care plan must show the "Majority requested provided by an RBT." Degreed skills trainers must become an RBT or BCAT within six months of enrollment. [1]
- **Daily limits / MUEs**: No benefit limit; units come from the authorized care plan. The Covered Services chapter lists ABA with Limits: "No. Services must be included in the plan of care," and a service authorization "annually, and a 180-day update"; hours are requested per week and per code on the care plan "With justification of units requested." Separately, ND Medicaid’s Procedure Code Look-Up Tool (data extracted October 4, 2026) prints a "Max Units" value on each code: 97151 32, 97152 16, 97153 32, 97154 18, 97155 24, 97156 16 and 0373T 32 (97157, 97158 and 0362T are not covered). The tool does not label the period those maximums cover; ask ND Medicaid (proccodelookup@nd.gov) before billing past them on one date. [3][4][1]
- **Session-note signature**: Records must be "signed by the ND Medicaid-enrolled provider rendering the service. Claims that do not have signed records are considered non-covered," with start and stop times "required for all time-based codes" and records kept at least seven years. The ABA care plan must carry the "Signature of the BCBA, and date of signature," and skills-training documentation must include "who with, time, where occurred, event, data of goal." [13][1]
- **Place of service**: Home, community or a provider’s facility ("Services can occur within the home, community, or a provider’s facility"); HHS also lists school. School-based ABA through the IEP is billable by enrolled schools, needs a BCBA-written care plan, and "Service authorization must be received and approved prior to services being rendered." Services that are "solely educational, vocational, recreational or social" are not paid. [1][2][14]
- **Bill as provider**: The rendering clinician’s own NPI. "All eligible providers must enroll and bill with their own NPI. Providers eligible to enroll may not bill for services under a supervising or peer provider’s NPI," and the servicing NPI must be enrolled on the date of service. Skills trainers (RBTs, BCATs and the other listed types) are enrolled provider types, so a technician’s session goes out under the technician’s NPI, not the supervising BCBA’s. No ORP (ordering/referring) NPI is required on the ABA codes. [10][1][5]
- **Concurrent billing (97153 + 97155):** Not published / unverified. Verify via: ND Medicaid Medical Services (dhsautism@nd.gov; service authorization questions dhsserviceauth@nd.gov): ask whether 97153 and 97155 may be billed for the same clock time; or check the Procedure Code Look-up Tool. [1][5]

## What intake should collect for North Dakota Medicaid

- **Prior approval letter:** The family gets it from ND Medicaid after sending a Health Tracks screening that lists the autism diagnosis and recommends ABA. It must be attached to every service authorization.
- **Health Tracks screening date:** Must be within six months of eligibility and renewed every year; the renewal screening may be done up to six months before the due date.
- **Diagnosis:** ASD diagnosis from the PCP or a licensed medical care provider qualified to diagnose it.
- **Age:** ABA codes are covered through age 20 only.
- **Other insurance:** ND Medicaid is generally the payer of last resort; bill the commercial plan first and follow its rules (secondary claims have 365 days).
- **Member ID card type:** A white BCBSND Medicaid Expansion card means an adult 21+; ABA is billed to ND Medicaid fee-for-service under the green ND Medicaid card.

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

## Common questions

### Does ND Medicaid require graphs for the ABA reassessment?

Yes. The ABA policy (February 2025) requires the assessment to include "Graphs on starting point and progress of data," expects readable graphs and standardized data collection when progress is monitored, and calls for a reassessment at 180 days that updates targets, goals, improvements and hours. Data should be reviewed so treatment changes after 4–6 weeks without improvement.

### Does North Dakota Medicaid cover ABA therapy?

Yes, for members under 21 with an autism spectrum disorder diagnosis. It is a fee-for-service benefit: the family sends a Health Tracks screening recommending ABA, gets a prior approval letter, and the provider requests service authorizations twice a year.

### Does a North Dakota Medicaid MCO cover ABA?

No. Medicaid Expansion is run by Blue Cross Blue Shield of North Dakota, but Expansion members aged 19–20 are enrolled in traditional Medicaid and ABA stops at age 20, so all ABA goes through ND Medicaid fee-for-service.

### What does North Dakota Medicaid pay for ABA?

Per unit, on the August 1, 2026 professional fee schedule: 97151 and 97155 $31.76, 97152 $23.51, 97153 $10.81, 97154 $2.72, 97156 $29.48, 0373T $12.99. 97157, 97158 and 0362T are not covered.

### Can a BCBA licensed in another state treat a North Dakota Medicaid member, including by telehealth?

Not without a North Dakota license. N.D.C.C. 43-64-02 requires a license from the Board of Integrative Health Care to practice ABA, and ND Medicaid enrolls only providers licensed under the law of the state where services are rendered. The board offers license by endorsement to analysts licensed in a substantially similar state. Providers more than 50 miles from the border also need an out-of-state service authorization.

### What is the timely filing limit for ND Medicaid ABA claims?

180 days from the date of service for an original claim; 365 days when another payer paid first or for a replacement of a timely claim. Payment denials can be reviewed if requested within 30 days.

### Does EVV apply to ABA in North Dakota?

No. The fee schedule lists EVV "No" for the ABA codes; EVV covers personal care, home health, 1915(i) and waiver respite and in-home supports, including the Autism waiver’s.

### Whose NPI goes on a North Dakota Medicaid ABA claim?

The rendering provider’s. ND Medicaid requires every eligible provider to enroll and bill with their own NPI and bars billing under a supervisor’s NPI; RBTs and other skills trainers are enrolled provider types.

### Does an ND Medicaid ABA claim need a referring or ordering provider (box 17)?

No. ND Medicaid’s Procedure Code Look-Up Tool marks every covered ABA code (97151–97156 and 0373T) "Ordering/Referring/Prescribing Provider NPI required: No." The PCP’s recommendation still matters, but it travels as the Health Tracks screening and the yearly prior approval letter attached to the service authorization, not on the claim.

### Can ABA and speech therapy be billed on the same day in North Dakota Medicaid?

Not by the same agency: the ABA policy says that if one agency provides both speech services and ABA to a child, "only one service may be billed per day." The policy says nothing about two different agencies, and ND Medicaid also will not pay for ABA components that "Duplicate other State Plan services."

## Primary sources

1. [ND Medicaid Policy and Procedures for the Autism Applied Behavior Analysis Service (revision February 2025; supersedes September 2017, June 1, 2018, July 2023)](https://www.hhs.nd.gov/sites/www/files/documents/autism-aba-service-policy-and-procedures.pdf)
2. [ND Health and Human Services — Children’s Waiver Services (Medicaid ABA service; Autism Spectrum Disorder Birth through Age 20 Waiver)](https://www.hhs.nd.gov/cfs/autism-services)
3. [ND Medicaid Billing and Policy Manual — Medicaid Covered Services (updated October 2025)](https://www.hhs.nd.gov/sites/default/files/documents/medicaid-policies/medicaid-covered-services.pdf)
4. [ND Medicaid Procedure Code Look-Up Tool (public Power BI report; ABA lines read 10/11/2026, data extracted 10/4/2026: Max Units, ORP NPI required, service authorization, telehealth)](https://www.hhs.nd.gov/healthcare/medicaid/provider/look-up-tool)
5. [ND Medicaid Professional Services Fee Schedule (data updated as of August 1, 2026; Autism category lines)](https://www.hhs.nd.gov/sites/default/files/documents/rate-2026-august-professional-fee-schedule.xlsx)
6. [ND Medicaid Autism Services Fee Schedule as of 7/1/2025 (archived)](https://www.hhs.nd.gov/sites/default/files/documents/website-archive/medical-services/rate-autism-2025-fee-schedule-archive.pdf)
7. [ND HHS — Rates and Fee Schedules](https://www.hhs.nd.gov/healthcare/medicaid/provider/fee-schedules)
8. [ND HHS — Provider Guidelines, Manuals and Policies (ND Medicaid Billing and Policy Manual chapters)](https://www.hhs.nd.gov/healthcare/medicaid/provider/manuals-and-guidelines)
9. [ND Medicaid Billing and Policy Manual — Service Authorizations (updated January 2026)](https://www.hhs.nd.gov/sites/www/files/documents/medicaid-policies/service-authorizations.pdf)
10. [ND Medicaid Billing and Policy Manual — Provider Enrollment](https://www.hhs.nd.gov/sites/default/files/documents/medicaid-policies/provider-enrollment.pdf)
11. [ND Medicaid Billing and Policy Manual — Claims Guidance (updated July 2026)](https://www.hhs.nd.gov/sites/default/files/documents/medicaid-policies/claims-guidance.pdf)
12. [ND Medicaid Billing and Policy Manual — Behavioral Health Rehabilitative Services (updated March 2026)](https://www.hhs.nd.gov/sites/default/files/documents/medicaid-policies/behavioral-health-rehabilitative-services.pdf)
13. [ND Medicaid Billing and Policy Manual — Provider Requirements (updated October 2025)](https://www.hhs.nd.gov/sites/default/files/documents/medicaid-policies/provider-requirements.pdf)
14. [ND Medicaid Billing and Policy Manual — School-Based Services (updated July 2026)](https://www.hhs.nd.gov/sites/www/files/documents/medicaid-policies/school-based-medicaid.pdf)
15. [ND Medicaid Billing and Policy Manual — Telehealth (updated October 2025)](https://www.hhs.nd.gov/sites/default/files/documents/medicaid-policies/telehealth.pdf)
16. [ND Medicaid Billing and Policy Manual — Timely Filing (updated October 2025)](https://www.hhs.nd.gov/sites/default/files/documents/medicaid-policies/timely-filing-policy.pdf)
17. [ND Medicaid Billing and Policy Manual — Third Party Liability (updated January 2026)](https://www.hhs.nd.gov/sites/default/files/documents/medicaid-policies/third-party-liability-tpl.pdf)
18. [ND Medicaid Billing and Policy Manual — Electronic Visit Verification (updated October 2025)](https://www.hhs.nd.gov/sites/default/files/documents/medicaid-policies/electronic-visit-verification.pdf)
19. [ND Medicaid Billing and Policy Manual — Member Eligibility (updated July 2026)](https://www.hhs.nd.gov/sites/default/files/documents/medicaid-policies/member-eligibility.pdf)
20. [ND Medicaid Billing and Policy Manual — Out-of-State Services (updated January 2026)](https://www.hhs.nd.gov/sites/www/files/documents/medicaid-policies/out-of-state-services.pdf)
21. [Application for 1915(c) HCBS Waiver ND.0842.R03.01 — Autism Spectrum Disorder (ASD) Birth through Twenty (approved effective 11/01/2025)](https://www.hhs.nd.gov/sites/default/files/documents/autism-spectrum-disorder-waiver-exclusion.pdf)
22. [N.D.C.C. ch. 43-64 — Behavior Analysts (license required from January 1, 2020; State Board of Integrative Health Care)](https://ndlegis.gov/cencode/t43c64.pdf)
23. [N.D. Admin. Code ch. 112-05-01 — Behavior Analysts (licensure, endorsement, exemptions; effective January 1, 2021)](https://ndlegis.gov/api/acdata/pdf/112-05-01.pdf)
24. [BACB — U.S. Licensure of Behavior Analysts (North Dakota: 2011, ND Board of Integrative Health Care)](https://www.bacb.com/u-s-licensure-of-behavior-analysts/)
25. [42 CFR 440.230(e) — State Medicaid agency prior-authorization timeframes (eCFR)](https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-C/part-440/subpart-B/section-440.230)
26. [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)
27. [BCBSND — Medicaid Expansion Provider Manual (BND-21-0027967, 6-26)](https://www.bcbsnd.com/content/dam/bcbsnd/documents/manuals/Medicaid-Expansion-Provider-Manual.pdf)
28. [ND HHS — Medicaid provider newsletters](https://www.hhs.nd.gov/healthcare/medicaid/provider/communications/newsletters)

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.