---
title: Oklahoma Complete Health ABA coverage (SoonerSelect).
url: "https://carelu.com/payers/oklahoma-complete-health"
markdown_url: "https://carelu.com/payers/oklahoma-complete-health.md"
state: OK (Oklahoma)
payer: Centene - Oklahoma Complete Health
kind: Medicaid managed care plan (MCO)
parent_program: Oklahoma Medicaid (SoonerCare / SoonerSelect) - Oklahoma Health Care Authority
description: "How Oklahoma Complete Health administers the SoonerCare ABA benefit: OK.CP.BH.500 adopting OHCA’s rules, prior authorization on 97151/97153/97155/97156, no group codes, 10% case supervision since June 2026, the 97151-TS reassessment modifier, the Children’s Specialty Program, and its decision clocks."
last_reviewed: October 2026
---

# Oklahoma Complete Health ABA coverage (SoonerSelect).

_Payer Guide · Oklahoma Complete Health · Last updated October 2026 · 17 primary sources_

> SoonerSelect MCO (Centene) and the only Children’s Specialty Program plan. OK.CP.BH.500 adopts OHCA’s ABA rules; 10% case supervision since 6/30/2026.

Oklahoma Complete Health is Centene’s SoonerSelect plan, and the one an ABA practice sees on every foster-care and child-welfare referral: OHCA states that the Children’s Specialty Program "covers SoonerSelect children and youth served by Oklahoma Human Services’ Child Welfare Services" and "Oklahoma Complete Health serves these members." Its ABA policy, OK.CP.BH.500 (revised August 2026), is written directly on OHCA’s Part 30 rules, so the state benefit is the clinical baseline. The plan’s own layer is operational and it moved in 2026: case supervision doubled to 10% of direct hours from June 30, group ABA was confirmed as not covered, and ABA reassessments carry modifier TS from September 16.

This plan administers the **Oklahoma Medicaid (SoonerCare / SoonerSelect) - Oklahoma Health Care Authority** ABA benefit: the state rules are the floor, and this page covers what the plan layers on top. Read it together with the [Oklahoma Medicaid (SoonerCare / SoonerSelect) - Oklahoma Health Care Authority guide](https://carelu.com/payers/oklahoma-medicaid).

## Prior authorization and diagnosis at a glance

- **Prior auth for the assessment**: Required — the plan’s Pre-Auth Check tool returns "Pre-authorization is required for all providers" for 97151 (and for 97153, 97155, 97156); the manual lists ABA as "Covered; prior authorization required." From 9/16/2026 a reassessment is billed as 97151 with modifier TS. [4][1][7]
- **Prior auth for treatment**: Required for 97153, 97155 and 97156 for all providers; the plan applies OHCA’s authorization rules (1–6 months of units, seven-day extension window) under OK.CP.BH.500. Group codes 97154, 97157 and 97158 are "not a covered benefit." [4][2][6][11][12]
- **Autism diagnosis required?**: Yes — under 21 and the member "has a definitive diagnosis of autism spectrum disorder (ASD)," certified by a provider in Oklahoma or within 50 miles of the border: a pediatric neurologist or neurologist, developmental pediatrician, licensed psychologist, psychiatrist or neuropsychiatrist, other licensed physician experienced in ASD, or an interdisciplinary team of a licensed psychologist, physician, PA or APRN (OK.CP.BH.500, revised 08/26). The diagnostic evaluation must be completed no more than two years before the initial request. [2][10]

## At a glance

- **Plan type:** SoonerSelect health plan (Centene) — also the Children’s Specialty Program plan
- **Clinical rules:** OK.CP.BH.500 adopts OHCA’s ABA rules (OAC 317:30-5-310 to -316); under 21 only
- **Prior auth:** 97151, 97153, 97155, 97156 — required for all providers (Pre-Auth Check, 9/2026)
- **Not covered:** Group ABA (97154, 97157, 97158); individual codes billed for group sessions are recouped
- **Case supervision:** 10% of direct treatment hours from 6/30/2026 (was 5%)
- **Reassessment:** 97151 with modifier TS in position 1 from 9/16/2026
- **Fee schedule:** Contracted; state law (56 O.S. § 4002.12) requires at least 100% of the OHCA fee schedule for in-network providers
- **Decision clock:** Standard 7 calendar days, expedited 72 hours (2026 manual)

## The state rules, adopted in the plan’s own policy

OK.CP.BH.500 covers ABA requests under "Title 317. Oklahoma Health Care Authority. Part 30" and repeats OHCA’s criteria: a member under 21 with a definitive ASD diagnosis from a named discipline, a comprehensive diagnostic evaluation with medical and social history and DSM criteria or formal test scores (ADI-R, ADOS-2, CARS; "Screening scales are not sufficient"), medical stability, and disruptive behaviour "within the last 30 days." The August 2026 revision brought the policy level with OHCA’s September 1, 2025 rule: it adds the interdisciplinary-team diagnostic path and the in-state-or-within-50-miles requirement, and requires the evaluation to be “completed no more than two years prior.” It also sets the 97151 assessment at up to 24 units, or 25 to 32 units when clinical complexity is documented; updated assessments at up to 16 units and no more often than every six months; and 97155 protocol modification at “at least two hours per week or 10% of the direct service hours provided, whichever is greater.” The 2026 manual lists ABA as "Covered; prior authorization required" for children and "Not Covered" for adults, and repeats that OHCA requires one-to-one delivery "except for approved family or caregiver guidance." [2][1][10]

## 2026 changes: supervision, group codes, reassessment modifier

Three provider notices changed the claim in 2026. On May 11 the plan reminded providers that "Group ABA therapy is not a covered benefit" and that billing individual ABA codes for group sessions is not permitted, with recoupment on audit. On May 15 it announced it was "increasing required case supervision from 5% to 10% of direct treatment hours," effective June 30, 2026 — double the 5% RBT floor in OHCA’s rule. On September 8 it announced that from September 16, 2026 every ABA reassessment billed as 97151 "must include modifier TS in Position 1," while prior authorization requests continue as before. The Centene documentation policy CP.BH.105 adds session-note rules: signatures and printed names of the member or guardian, rendering clinician or technician and supervising practitioner, cameras on for telehealth sessions, and 97155 protocol-modification visits that do not exceed eight units a day. [6][5][7][3][18]

## Submitting and timing requests

The manual names the Availity portal as the preferred route for prior authorization, with a fax form (Physical/Behavioral Health fax 1-844-565-0273) for portal downtime; plan phone 833-752-1664, or 833-752-1665 for Children’s Specialty Program members. The manual’s timeframes are "Standard Preservice/Non-Urgent Within 7 calendar days" and 72 hours expedited, in line with state law (56 O.S. § 4002.6) and 42 CFR 438.210(d). The plan’s older fax form (rev. July 2024) still prints a 72-hour standard turnaround; the 2026 manual controls. [1][8][13][19]

## Switching agencies, the payment floor, and joining the network

Oklahoma Complete Health’s own policy, OK.CP.BH.500 (revised 08/26), carries the state rule on changing agencies: “If the member/enrollee changes ABA agencies, the CDE or clinical assessment is required during initial authorization period,” and “An OHCA discharge notification form must be submitted when a member/enrollee has completed treatment, transferred to a new provider, or will no longer be returning to care.” For a child new to the plan, the 2026 manual says the plan “will continue to authorize care as needed during a 90-day continuity of care period” and that “In the event of a change of MCO for the Member during an episode of care, Oklahoma Complete Health will work with the Provider and the new MCO to ensure any needed continued authorization of care that is medically necessary are in place.” [2][1][14][15][16]

56 O.S. § 4002.12 sets a floor on what SoonerSelect plans pay: at least 100% of the OHCA fee schedule rate for a participating, in-network provider, and 90% of the OHCA rate as of January 1, 2021 for an out-of-network provider. The version in force through October 31, 2026 runs that floor “Until July 1, 2027”; HB 3650 (Laws 2026, c. 310), effective November 1, 2026, extends it to July 1, 2028. Whether the plan is adding ABA providers is a question for its provider relations team. [2][1][14][15][16]

## Claims: filing deadline, payment clock and disputes

The plan’s Provider Billing Manual: "Providers must submit all first-time claims for reimbursement no more than one hundred eighty 180 calendar days from the Date of Service," adjustments go in writing within 180 calendar days of the EOP or ERA (and never 365 days or more past the date of service), and the plan pays 1.5% monthly interest on clean claims "not adjudicated within forty-five (45) Days of receipt," citing 62 O.S. § 34.72. The state rule for every SoonerSelect plan is tighter on payment: at least 90% of clean claims paid within 14 days, with six months from the date of service treated as timely (OAC 317:55-5-25; 56 O.S. § 4002.7). [20][1][21][22]

Bill your NPI in box 24J; the billing manual encourages the taxonomy code in box 24Ja as well, and returns claims missing required data as not clean. On disputes the plan’s two documents differ: the 2026 Provider Manual allows a claim dispute or claim appeal "within 180 calendar days of the Explanation of Payment (EOP)," with a second-level medical-necessity appeal within 60 days of the first decision, while the billing manual says appeals of adverse actions "must be filed in writing within 60 days calendar days of the date of the EOP or ERA." File inside the shorter window. Electronic visit verification (AuthentiCare) covers home health and State Plan personal care services, not ABA. [20][1][21][22]

## Intake gates

The questions that decide whether a family can start with Centene - Oklahoma Complete Health, and what they have to bring.

- **Age limit**: Follows the SoonerCare rule: Under 21. OAC 317:30-5-313 requires that "The member is under twenty-one (21) years of age," and OHCA provides ABA "under the EPSDT benefit" (OAC 317:30-3-65.12). No lower age bound is set. (OHCA’s provider application page words it as "ages 21 and younger"; the rule text says under 21.) Oklahoma Complete Health was checked for its own rule on this point and publishes nothing different, so the OHCA rule applies. [10][28][27][2][1]
- **Diagnosis recency**: OK.CP.BH.500 (revised 08/26): the comprehensive diagnostic evaluation or clinical assessment is "Submitted at the initial request for ABA treatment and completed no more than two years prior"; annual or biannual re-evaluations are not required, and "If the member/enrollee changes ABA agencies, the CDE or clinical assessment is required during initial authorization period." Disruptive behaviour must be documented "within the last 30 days." [2][10]
- **Who may diagnose**: OK.CP.BH.500 (revised 08/26) lists a pediatric neurologist or neurologist, developmental pediatrician, licensed psychologist, psychiatrist or neuropsychiatrist, other licensed physician experienced in diagnosing and treating ASD, or an interdisciplinary team of a licensed psychologist, physician, physician assistant or APRN, located in Oklahoma or within 50 miles of the border. Out-of-state evaluations must meet the same documentation rules and come from one of these providers. [2][10]
- **Diagnostic tools required**: Follows the SoonerCare rule: No single instrument is mandatory. The evaluation must include a complete medical and social history and be "based on criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM)", and "may also include scores" from formal tests such as the ADI-R, ADOS-2 or CARS "or other tools with acceptable psychometric properties." "Screening scales are not sufficient to make a diagnosis and will not be accepted as the only formal scale." For the ABA clinical assessment itself, OHCA cites validated measures such as the Vineland, and accepts supporting assessments such as the ABLLS-R, AEPS and VB-MAPP with the PA request. Oklahoma Complete Health was checked for its own rule on this point and publishes nothing different, so the OHCA rule applies. [10][23][11][2][1]
- **Referral required?**: Neither OK.CP.BH.500 nor the manual’s ABA entry requires a physician referral; the gate is prior authorization of 97151, 97153, 97155 and 97156. OHCA’s rule requires no referral either. [2][1][4][11]
- **Telehealth**: The manual allows telehealth subject to the same rules as in-person care and defers billing to the billing manual, which has no ABA content; CP.BH.105 requires cameras on and working audio for telehealth sessions and bars 97155 protocol-modification visits by telehealth "unless allowed by state guidelines." OHCA’s rule applies underneath: telehealth justified in the PA, and 97151, 97155 and 97156 (not 97153) on OHCA’s telehealth code list. [1][3][11][25]
- **Prior-auth decision time**: The 2026 manual: "Standard Preservice/Non-Urgent Within 7 calendar days," expedited 72 hours, concurrent review 3 calendar days. State law (56 O.S. § 4002.6) sets the same 7 days and 72 hours from receipt of all necessary information and deems the service authorized if a complete portal request is not decided in time. Extensions follow OHCA’s seven-day window. The plan’s 2024 fax form still prints "no later than 72 hours" for standard requests; the manual is newer. [1][13][8][12]
- **Other insurance (who pays first)**: "Oklahoma Complete Health, like all Medicaid programs, is always the payer of last resort." Bill the primary payer first and attach its EOB/EOP; a member with more than one primary insurance needs a paper claim. The manual names pay-and-chase for "Preventive Pediatric services, including Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)" but does not say whether ABA is treated that way, so bill the primary first. OHCA’s rule adds that the state’s authorization meets the primary insurer’s PA requirement. [1][29]

## Delivery and billing rules

Coverage decides whether Centene - Oklahoma Complete Health 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**: Case supervision of at least 10% of direct treatment hours from June 30, 2026 ("increasing required case supervision from 5% to 10% of direct treatment hours"), above OHCA’s 5% monthly RBT floor. OHCA’s conditions for concurrent RBT and supervision billing still apply. [5][18][11]
- **Concurrent billing (97153 + 97155)**: Follows the SoonerCare rule: Allowed, with conditions. "Providers may only concurrently bill RBT and supervision hours when the following criteria is outlined in the prior authorization request," and the BCBA or licensed psychologist must have directed the RBT in session. "ABA is not allowed to be billed concurrently during any other therapies (i.e., OT, PT speech, etc.)," and "ABA hours approved for one CPT code cannot be used in place of another." Oklahoma Complete Health was checked for its own rule on this point and publishes nothing different, so the OHCA rule applies. [11][2][1]
- **Daily limits / MUEs**: No per-day cap on direct treatment beyond OHCA’s authorization limits, but CP.BH.105 limits 97155 protocol-modification visits to eight units (two hours) a day, and group codes are not covered. OK.CP.BH.500 (revised 08/26) caps the 97151 assessment at 24 units per authorization period, or 25 to 32 units with documented clinical complexity, and updated assessments at 16 units no more often than every six months (up to 32 case by case). OHCA’s intensity tiers apply. [3][6][10][11]
- **Session-note signature**: CP.BH.105: documentation carries the "signature and printed names of the member/enrollee, legal guardian, rendering clinician/technician and supervising practitioner (as applicable)," each note the "Signature of qualified rendering provider/technician," start and stop times, pauses and location; discharge summaries need the rendering provider’s and caregiver’s signatures. OHCA’s treatment-plan signature rule applies underneath. [3][23]
- **Place of service**: Follows the SoonerCare rule: Home, community or clinic ("ABA may be provided in a variety of settings, including home, community, or clinical"). "ABA services are not allowed in a daycare setting or school setting, without OHCA approval. If approved, it will be time-limited to three (3) months or less," with a plan to fade support to school staff; private-school transitions are also capped at three months. School or daycare shadowing and aide work is excluded. Telehealth is allowed if justified in the PA (97151, 97155, 97156 on OHCA’s telehealth code list). Oklahoma Complete Health was checked for its own rule on this point and publishes nothing different, so the OHCA rule applies. [24][11][25][2][1]
- **Bill as provider** _(ask the plan)_: The plan’s manuals publish only the generic CMS-1500 rule (rendering NPI in box 24J), and OK.CP.BH.500 adopts OHCA’s provider rules, under which BCaBAs and RBTs are not paid directly and payment goes to the supervising BCBA or employing agency. Whether the plan wants the RBT’s NPI as rendering is not stated. [1][2][26][27]
  - Ask the plan: Oklahoma Complete Health provider services (833-752-1664) or the Availity claim edits: ask whose NPI goes in box 24J for 97153 delivered by an RBT.

## What intake should collect for Centene - Oklahoma Complete Health

- **Children’s Specialty Program or general SoonerSelect:** Foster, former foster, adoption-assistance and juvenile-justice children are on the Children’s Specialty Program (833-752-1665). Same plan, different member line.
- **Diagnosis report, date and diagnostician:** A definitive ASD diagnosis from a discipline OAC 317:30-5-313 names, in Oklahoma or within 50 miles, no older than two years at the start of ABA.
- **Behaviour from the last 30 days:** Required by the state medical-necessity rule the plan applies.
- **Current authorization end date:** The OHCA seven-day extension window applies to plan members too.
- **Parent training capacity:** Under two hours a month of documented parent involvement reduces or denies hours under the state rule.
- **Supervision staffing:** Plan for BCBA case supervision at 10% of direct hours, not 5%.

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

## Common questions

### Does Oklahoma Complete Health cover ABA therapy?

Yes, for members under 21 with a definitive ASD diagnosis, with prior authorization on 97151, 97153, 97155 and 97156. Adults are not covered.

### Does Oklahoma Complete Health cover group ABA?

No. Group codes 97154, 97157 and 97158 are not covered, and individual codes may not be billed for group sessions.

### How much case supervision does Oklahoma Complete Health require?

At least 10% of direct treatment hours since June 30, 2026, up from 5%.

### Which plan covers ABA for a child in foster care in Oklahoma?

Oklahoma Complete Health, through the SoonerSelect Children’s Specialty Program (member line 833-752-1665).

### What happens if a family switches ABA agencies with Oklahoma Complete Health?

The diagnostic evaluation or clinical assessment is required again during the new agency’s initial authorization period, and an OHCA discharge notification form is filed when a member transfers to a new provider.

### What does Oklahoma Complete Health pay for ABA?

Rates are set in your contract, but state law (56 O.S. § 4002.12) requires SoonerSelect plans to pay in-network providers at least 100% of the OHCA fee schedule rate (97153 is $17.35 per unit from 7/1/2026).

### What is Oklahoma Complete Health’s timely filing limit for ABA claims?

180 calendar days from the date of service for a first-time claim, and 180 days from the EOP for an adjustment (Provider Billing Manual).

## Primary sources

1. [Oklahoma Complete Health — 2026 Provider Manual (Caid_SSP.CSP-Provider-Manual-OK-Eng_260604)](https://www.oklahomacompletehealth.com/content/dam/centene/oklahoma-complete-health/pdfs/Provider%20Manual/English/2026/SSP/Provider%20Manual_2026.5_Approved_R.pdf)
2. [Oklahoma Complete Health clinical policy OK.CP.BH.500 — Applied Behavioral Analysis (last revised 08/26)](https://www.oklahomacompletehealth.com/content/dam/centene/oklahoma-complete-health/policies/clinical-policies/OK.CP.BH.500.pdf)
3. [Centene clinical policy CP.BH.105 — ABA Documentation Requirements (revised 11/25), posted by Oklahoma Complete Health](https://www.oklahomacompletehealth.com/content/dam/centene/oklahoma-complete-health/policies/clinical-policies/CP.BH.105.pdf)
4. [Oklahoma Complete Health — Medicaid Pre-Auth Check tool (queried 9/24/2026 for 97151–97158, 0362T, 0373T)](https://www.oklahomacompletehealth.com/providers/preauth-check/medicaid-pre-auth.html)
5. [Oklahoma Complete Health — ABA Case Supervision Update (5/15/2026; 10% effective 6/30/2026)](https://www.oklahomacompletehealth.com/providers/provider-news/aba-case-supervision-update.html)
6. [Oklahoma Complete Health — ABA Coverage Reminder (5/11/2026; group ABA not covered)](https://www.oklahomacompletehealth.com/providers/provider-news/aba-provider-.html)
7. [Oklahoma Complete Health — For Providers: ABA Billing Requirements (9/8/2026; 97151-TS from 9/16/2026)](https://www.oklahomacompletehealth.com/providers/provider-news/for-providers--aba-billing-requirements.html)
8. [Oklahoma Complete Health — Outpatient Prior Authorization Fax Form (OK-PAF-6374, rev. 7/29/2024)](https://www.oklahomacompletehealth.com/content/dam/centene/oklahoma-complete-health/OK-OP-PAF-6374-GTU.pdf)
9. [OHCA — Learn about SoonerSelect (last modified 6/9/2026)](https://oklahoma.gov/ohca/soonerselect/about.html)
10. [OAC 317:30-5-313 — Medical necessity criteria, covered services, frequency and duration Revised 09-01-25](https://oklahoma.gov/ohca/policies-and-rules/xpolicy/medical-providers-fee-for-service/individual-providers-and-specialties/applied-behavior-analysis-services/medical-necessity-criteria-and-covered-services-for-members-under-twenty-one-years-of-age-and-frequency-and-duration.html)
11. [OAC 317:30-5-314 — Prior authorization, service limitations, and exclusions to treatment Revised 09-01-25](https://oklahoma.gov/ohca/policies-and-rules/xpolicy/medical-providers-fee-for-service/individual-providers-and-specialties/applied-behavior-analysis-services/prior-authorization-service-limitations-and-exclusions-to-treatment.html)
12. [OAC 317:30-5-315 — ABA extension requests Revised 09-01-25](https://oklahoma.gov/ohca/policies-and-rules/xpolicy/medical-providers-fee-for-service/individual-providers-and-specialties/applied-behavior-analysis-services/aba-extension-requests.html)
13. [56 O.S. § 4002.6 — SoonerSelect contracted entity prior authorization rules (as amended by HB 1810, eff. 11/1/2025) — OSCN](https://www.oscn.net/applications/oscn/DeliverDocument.asp?CiteID=489236)
14. [56 O.S. § 4002.12 — SoonerSelect minimum provider reimbursement (as amended by HB 3650, Laws 2026, c. 310, eff. 11/1/2026) — OSCN](https://www.oscn.net/applications/oscn/DeliverDocument.asp?CiteID=489244)
15. [56 O.S. § 4002.12 — version in force through 10/31/2026 ("Until July 1, 2027") — OSCN superseded document](https://www.oscn.net/applications/oscn/DeliverDocument.asp?CiteID=553197)
16. [OHCA — SoonerCare Title XIX fee schedule, effective 07/01/2026 (V3)](https://oklahoma.gov/content/dam/ok/en/okhca/docs/providers/claim-tools/fee-schedules/2026/Prov_fee_sch_TXIX_07012026_V3.txt)
17. [Oklahoma Complete Health — Provider News (provider notices archive)](https://www.oklahomacompletehealth.com/providers/provider-news.html)
18. [OAC 317:30-5-311 — Eligible providers and requirements Revised 09-01-25](https://oklahoma.gov/ohca/policies-and-rules/xpolicy/medical-providers-fee-for-service/individual-providers-and-specialties/applied-behavior-analysis-services/eligible-provider-and-requirements.html)
19. [42 CFR 438.210(d) — Medicaid managed care authorization timeframes (eCFR)](https://www.ecfr.gov/current/title-42/section-438.210)
20. [Oklahoma Complete Health — Provider Billing Manual (posted in the 2026 manuals folder; page footer reads 2024)](https://www.oklahomacompletehealth.com/content/dam/centene/oklahoma-complete-health/pdfs/Provider%20Manual/English/2026/SSP/2026%20Provider%20Billing%20Manual_Approved_R.pdf)
21. [OAC 317:55-5-25 — SoonerSelect claims processing and methodology; post payment audits Revised 09-01-24](https://oklahoma.gov/ohca/policies-and-rules/xpolicy/managed-care/requirements-for-contracted-entities-and-dental-benefits-managers/finance/claims-processing-and-methodology-post-payment-audits.html)
22. [56 O.S. § 4002.7 — SoonerSelect claims processing and adjudication — OSCN](https://www.oscn.net/applications/oscn/DeliverDocument.asp?CiteID=489238)
23. [OAC 317:30-5-312 — Treatment plan components and documentation requirements Revised 09-01-25](https://oklahoma.gov/ohca/policies-and-rules/xpolicy/medical-providers-fee-for-service/individual-providers-and-specialties/applied-behavior-analysis-services/treatment-plan-components-and-documentation-requirements.html)
24. [OAC 317:30-5-310 — ABA purpose ("ABA services require prior authorization") Issued 09-12-22](https://oklahoma.gov/ohca/policies-and-rules/xpolicy/medical-providers-fee-for-service/individual-providers-and-specialties/applied-behavior-analysis-services/purpose-aba.html)
25. [OHCA — Medical codes allowed for Telehealth (updated 8-10-26)](https://oklahoma.gov/content/dam/ok/en/okhca/docs/providers/telehealth/Medical%20codes%20allowed%20for%20Telehealth.pdf)
26. [OAC 317:30-5-316 — ABA reimbursement methodology Revised 09-01-25](https://oklahoma.gov/ohca/policies-and-rules/xpolicy/medical-providers-fee-for-service/individual-providers-and-specialties/applied-behavior-analysis-services/reimbursement-methodology.html)
27. [OHCA — Applied Behavioral Analysis Application and Coding Information for Providers](https://oklahoma.gov/ohca/providers/applied-behavioral-analysis-application.html)
28. [OAC 317:30-3-65.12 — ABA services under the EPSDT benefit Revised 09-12-22](https://oklahoma.gov/ohca/policies-and-rules/xpolicy/medical-providers-fee-for-service/general-provider-policies/early-and-periodic-screening-diagnostic-and-treatment-program-child-health-services/applied-behavior-analysis-services.html)
29. [OAC 317:30-3-24 — Third party liability Revised 09-01-25](https://oklahoma.gov/ohca/policies-and-rules/xpolicy/medical-providers-fee-for-service/general-provider-policies/general-scope-and-administration/third-party-liability.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.