---
title: "UnitedHealthcare / Optum ABA coverage in Idaho: the intake guide."
url: "https://carelu.com/payers/unitedhealthcare-idaho"
markdown_url: "https://carelu.com/payers/unitedhealthcare-idaho.md"
state: ID (Idaho)
payer: UnitedHealthcare / Optum in Idaho
kind: Commercial insurance
description: "How UnitedHealthcare / Optum covers ABA for Idaho families: Optum’s Supplemental Clinical Criteria, separate assessment and treatment authorizations, no Idaho state-mandate supplement, Idaho’s Bulletin 18-02 and what intake should verify."
last_reviewed: October 2026
---

# UnitedHealthcare / Optum ABA coverage in Idaho: the intake guide.

_Payer Guide · UnitedHealthcare · Idaho · Last updated October 2026 · 17 primary sources_

> Optum ABA criteria (no Idaho supplement) + Idaho’s Bulletin 18-02; assessment and treatment both authorized.

UnitedHealthcare runs ABA through Optum Behavioral Health, under Optum’s ABA Supplemental Clinical Criteria. We checked Optum’s State Mandates supplement (effective July 2026). It has entries for Arizona, California, Connecticut, Florida, Indiana, Massachusetts, New Jersey, Ohio, Pennsylvania and Virginia, but none for Idaho, so the national criteria apply unchanged. Idaho has no Medicaid managed-care plan that handles ABA, so in Idaho a UnitedHealthcare card for a child is a commercial card.

## Prior authorization and diagnosis at a glance

- **Prior auth for the assessment**: Required — Optum authorizes the ABA assessment separately from treatment via the Provider Express portal [4][2]
- **Prior auth for treatment**: Required — "Prior authorization is required for ABA" unless otherwise specified or mandated by contract or law. Reviews: “At a minimum, most treatment reviews are required every 4-6 months depending on the account/state law” (Optum ABA CPT FAQ) [10][2][4]
- **Autism diagnosis required?**: Yes — DSM-5-TR ASD confirmed by the diagnosing clinician with at least one clinically validated tool [2]

## At a glance

- **Covers ABA?:** Yes, for ASD per Optum’s ABA Supplemental Clinical Criteria
- **State mandate:** No autism statute — Idaho DOI Bulletin No. 18-02 (2018) requires ASD treatment on state-regulated plans that cover rehabilitative or habilitative services (plan years from 1/1/2019)
- **Mandate age:** None — the bulletin sets no age limit
- **Mandate caps:** None separate — no separate dollar or visit limits; cost-sharing in parity with other mental health and med/surg benefits
- **Exempt from mandate:** Self-funded employer (ERISA) plans Idaho does not regulate; plans with no rehabilitative/habilitative benefit fall outside the bulletin’s trigger
- **Licensure:** None — Idaho has no behavior-analyst licensure law; BACB certification governs

## The national policy, applied in Idaho

Optum’s criteria state that "Prior authorization is required for ABA (unless otherwise specified or mandated by contract or law)." The Provider Express ABA page has providers "Request ABA assessment and treatment authorizations" in the portal, choosing "ABA Assessment or Treatment" for each request. The diagnosis must come from "a state licensed physician, psychologist, or other state licensed clinician" and be confirmed "using at least one clinically validated tool." Direct case supervision "is required 1–2 hours for every 10 hours of direct" treatment. Continued-service review looks specifically at utilization below 80% of authorized hours over a two-week period. Services covered under IDEA, or a 1:1 aide during classroom instruction, are excluded. [2][4][3]

## The Idaho coverage floor: Bulletin 18-02, not a statute

Idaho is one of the few states with no autism insurance statute, and intake should say so plainly. What Idaho has instead is Department of Insurance Bulletin No. 18-02 (April 2, 2018). Reading the federal Mental Health Parity and Addiction Equity Act, ACA § 1557 and the state’s Essential Health Benefits together, the Department declared that it "will consider an exclusion of treatments for autism spectrum disorder as discriminatory and prohibited when a plan includes coverage of rehabilitative or habilitative services, such as coverage of occupational therapy or speech therapy." It applies to the individual, small-group and large-group insured markets, and to self-funded plans subject to Idaho Code title 41, chapters 40 or 41, for plan years starting on or after January 1, 2019. Covered treatment must be "consistent with other mental health services (including applicable deductibles, copayments, or coinsurance), not subject to any separate dollar limits or visit limits, and in parity with medical and surgical benefits." The bulletin defines treatment as "evidence-based care and related equipment prescribed or ordered for an individual diagnosed with an autism spectrum disorder by a licensed physician or a licensed psychologist who determines the care to be medically necessary, including but not limited to behavioral health treatment" — it does not name ABA by name, and it sets no age limit. Carriers may still review medical necessity and "periodically review the medical necessity of continuing" treatment. Two practical limits: a bulletin is weaker than a statute, and a self-funded employer plan the Department does not regulate (most ERISA plans) sits outside it entirely — plan funding type is the first fact to establish. [5]

## Licensure & rates in Idaho

Idaho has no behavior-analyst licensure law and is not on the BACB’s list of licensing states, so Optum’s "Master- or Doctoral-level provider that is a Board-Certified Behavior Analyst" is the Idaho path. UnitedHealthcare publishes no commercial ABA rates, and they are negotiated in your agreement. [6][2]

## Claims: filing deadline and disputes

UnitedHealthcare’s ABA benefit is managed by Optum Behavioral Health, whose National Network Manual (effective September 1, 2026) requires everything needed to process a claim to reach Optum “no more than 90 calendar days from the date of service, or as allowed by state or federal law or the member’s specific benefit plan,” with corrections within 90 days of first receipt. Clean, authorized claims are “generally” paid within 45 calendar days of receipt or as state or federal law requires. Disputes run in two steps — reconsideration, then appeal — with 12 months in total for both unless state law or your participation agreement sets a different deadline. [11][1][17]

Optum’s National Network Manual (effective September 1, 2026) also sets the payment clock: claims with all required information and any required authorization "will be paid within 45 calendar days after Optum receives the claim, or as required by state and federal laws," which may exclude claims needing a coordination-of-benefits determination, and when Optum is secondary it pays up to the Optum contracted rate. UnitedHealthcare’s 2026 administrative guide adds that a corrected claim (frequency code 7, with the original claim number) must arrive within the same timely-filing limit as the original. No weekly payment cycle or submission cutoff is published. [11][1][17]

Which codes: Optum’s commercial ABA reimbursement policy (2022RP501A, updated June 2026) lists the reimbursable codes for the commercial ABA program as 97151–97158, 0362T and 0373T, each in 15-minute units with a credential modifier (HM, HN, HO or HP); no HCPCS H-code (H0031, H0032, H2014, H2019) is on that list. [11][1][17]

## How fast must UnitedHealthcare pay a clean claim in Idaho?

Idaho’s prompt-pay clock depends on how fast the provider files. Under Idaho Code § 41-5602, if an electronic claim is submitted within thirty days of the date of service, the insurer “shall pay or deny the claim not later than thirty (30) days after receipt”; a paper claim submitted within forty-five days of service must be paid or denied within forty-five days. A denial or request for more information must be sent in writing within the same thirty or forty-five days and must describe everything needed, after which the insurer has thirty days from receiving it. Late claims accrue interest at the statutory contract rate (§ 41-5603). The time limits do not apply where the insurer is complying with a provider contract that sets different payment terms (§ 41-5605(3)). These statutes bind fully insured plans issued in the state; a self-funded employer plan (ERISA) is not subject to them and follows its plan documents and your contract. [14][15][16]

## Does UnitedHealthcare need a referring provider on the ABA claim?

Not for ABA. Optum, which manages UnitedHealthcare’s behavioral benefit, says in its National Network Manual (effective September 1, 2026) that a claim must carry the coding (ICD diagnosis, CPT/HCPCS and modifiers), the member ID number, customary charges, and the provider’s TIN and NPI. Paper Form 1500 claims add the member and subscriber names and dates of birth, the length of session, the type and duration of service, and the clinician’s name, credentials, Tax ID and NPI. A referring provider is not on either list. [17][1]

UnitedHealthcare’s 2026 administrative guide requires the referring provider’s name and NPI only on laboratory, DME, imaging and home health claims. For every other claim, it requires “a valid billing NPI, rendering NPI and relevant taxonomy code(s)” and says “we encourage you to submit the referring health care provider’s NPI.” In short, the referring NPI is optional on an ABA claim, and leaving it off is not a denial reason under either document. [17][1]

## What must a UnitedHealthcare ABA reauthorization request contain, and are graphs required?

Optum’s ABA Supplemental Clinical Criteria (interim review April 2026) say that "With each clinical review for continued ABA treatment, the provider must submit updated documentation" showing progress "for each targeted symptom and behavior, including progress toward defined goals, including the same modes of measurement that were utilized for baseline measurement." Progress "should include rate and percentage of mastered programs, rates of mastered targets, change scores for any outcome measures, updated standardized adaptive measures, and change scores for skills-based assessments," with movement from baseline shown on validated, norm-referenced assessments and, where applicable, the caregiver’s own progress. Inadequate progress over six months calls for an analysis of the reasons and modified interventions, and the review looks at use below 80 percent of authorized hours over two weeks. The criteria do not require graphs as such. [2]

## Intake gates

The questions that decide whether a family can start with UnitedHealthcare / Optum in Idaho, and what they have to bring.

- **Diagnosis recency**: No expiry on the diagnosis. The DSM-5-TR diagnosis and severity level must be confirmed and documented with a validated tool, and review clocks run on progress: lack of progress within 6 months triggers reassessment and plan changes. [2]
- **Who may diagnose**: "A state licensed physician, psychologist, or other state licensed clinician qualified to make such diagnosis according to the diagnostic criteria based on the DSM-5-TR." [2]
- **Diagnostic tools required**: At least one clinically validated tool, from a non-exhaustive three-tier list. First-level screens: ABC, CHAT/M-CHAT, CSBS-DP-IT, ASQ, AQ, CAST. Second-level: CARS/CARS-2, RITA-T, STAT. Formal diagnostic tools: ADI-R, ADOS/ADOS-2, DISCO. [2]
- **Referral required?**: The SCC require prior authorization, not a separate referral. For Idaho state-regulated plans, Bulletin 18-02 frames covered treatment as care "prescribed or ordered" by a licensed physician or licensed psychologist, so get a written prescription. [2][5]
- **Telehealth**: Three codes, after an attestation. Optum’s Telehealth Billing guide (updated September 2025) is explicit for commercial plans: “For ABA services, telehealth is only allowed for these 3 CPT codes: 97155, 97156 or 97157” — virtual supervision of technicians and family training — so technician-delivered 97153 is not payable by telehealth, and neither is the 97151 assessment or the technician-assisted 97152: plan the assessment in person. The provider must first be “an approved Optum virtual visits provider who has attested” (the virtual-visits attestation on Provider Express) and must tell the ABA Care Advocate at authorization. Bill the in-person code with the member’s location as the place of service: POS 10 when the member is at home, POS 02 anywhere else (the older ABA CPT FAQ says POS 02; the 2025 guide requires one of the two on every behavioral-health telehealth claim, and POS 11 or a telehealth modifier alone is not paid). Optum’s criteria add that telehealth is “not intended to supplant in-person service.” [12][10][2]
- **Age limit** _(plan-dependent)_: The SCC carry no age criterion, and coverage turns on the member’s benefit plan. Bulletin 18-02 sets no age limit for state-regulated plans, and self-funded plans may carry their own terms. [2][5]
  - Ask the plan: Provider Express benefits check or the behavioral health number on the member card — establish fully insured vs. self-funded first.
- **Prior-auth decision time** _(plan-dependent)_: Turns on how the plan is funded. Idaho’s Managed Care Reform Act requires a managed care organization to answer a nonemergency prior-authorization request "within two (2) business days after complete member medical information is provided," "unless exceptional circumstances warrant a longer period" (Idaho Code § 41-3930). Self-funded ERISA plans follow 29 CFR 2560.503-1: 15 days, one 15-day extension, and 72 hours for urgent claims. [7][8]
  - Ask the plan: At benefits verification ask whether the plan is fully insured or self-funded, then confirm Optum’s turnaround and continuation lead time (Provider Express support 1-866-209-9320).
- **Other insurance (who pays first)** _(plan-dependent)_: For a child on two parents’ plans, Idaho’s rule (IDAPA 18.04.14.022) makes "the plan of the parent whose birthday falls earlier in the calendar year" primary, with separate rules for divorced or separated parents. Self-funded plans follow their own documents. If the child also has Idaho Medicaid, this plan pays first because Medicaid is the payer of last resort, and Medicaid pays CHIS on H-codes. TRICARE pays after this plan (10 U.S.C. 1079(i)(1)), and CHAMPVA is the last payer (38 CFR 17.270). [9][18][19][20]
  - Ask the plan: Ask UnitedHealthcare/Optum at benefits verification for the coordination-of-benefits order on file, and record every other coverage the child has.

## Delivery and billing rules

Coverage decides whether UnitedHealthcare / Optum in Idaho 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**: Consistent with CASP standards of care, "direct case supervision is required 1–2 hours for every 10 hours of direct" treatment. Technicians must be under the supervision of a BCBA or licensed behavioral health clinician and should be RBTs or another appropriately certified technician. Optum does not recommend that parents serve as RBTs for their own child. [2]
- **Concurrent billing (97153 + 97155)**: Yes, with a single-provider exclusion. Optum’s commercial ABA reimbursement policy: “Can I report 97153 or 97154 with 97155 concurrently? A. Yes, as long as the criteria in the descriptors of both codes are met. A single QHP may not report 97153 or 97154 with 97155 concurrently.” So the overlap has to be two people — a technician on 97153 and an analyst on 97155 directing them with the patient present. Optum’s ABA CPT FAQ adds that 97153 and 97156 “may be billed concurrently” as separate services to different family members by different providers. 97155 and 97156 on the same date pay only if “separate, distinct, and clearly documented in the progress notes” — “A single provider can’t bill for both simultaneously.” Team meetings bill only as supervision with the member, supervisor and technician present, and “CPT codes 97153 and 97155 may not be billed for technician training.” [11][10]
- **Daily limits / MUEs**: Optum’s commercial ABA reimbursement policy (2022RP501A, updated June 2026) sets a maximum frequency per day for every code: 97151 32 units (8 hrs), 97152 16 (4 hrs), 97153 32 (8 hrs), 97154 18 (4.5 hrs), 97155 24 (6 hrs), 97156 16 (4 hrs), 97157 16 (4 hrs), 97158 16 (4 hrs), 0362T 16 (4 hrs), 0373T 32 (8 hrs) — and “If a provider bills in excess of 32 units per day, claims may be subject to non-reimbursement or recovery.” The ABA CPT FAQ confirms “For our commercial ABA program MUE’s apply.” There is no weekly hour cap: hours are authorized on documented clinical need, approved units can be shifted among codes within a cluster, and utilization below 80% of authorized hours over a two-week period is addressed at review. Bulletin 18-02 bars separate dollar or visit limits on state-regulated plans. [11][10][2][5]
- **Session-note signature**: “Provider signature is required on progress notes. Parent/guardian signatures are not required on progress notes” (Optum ABA CPT FAQ). Each daily session note records place of service, start and stop time, who rendered the service, the specific service, who attended and the interventions. Optum’s ABA documentation protocol (June 1, 2026) requires the “signature of the rendering provider” and “Legible identity of the rendering provider with credentials,” and “The date of signature must reflect the date the note is finalized” — a note signed after the date of service must follow late-entry rules and show the date it was signed. Same-date services must be “separate, distinct, and clearly documented in the progress notes,” or the claim may be denied. [10][13][11]
- **Place of service**: ABA is provided "at the least restrictive and most clinically appropriate level." Not covered: "Services that are not ABA therapy, such as 1:1 aid delivered simultaneously during classroom instruction, or services covered under the Individuals with Disabilities Education Act (IDEA)." School ABA does cover coordination, teacher training, meetings with school staff and observation in the school setting. [2]
- **Bill as provider**: Once the diagnosis is confirmed, a credentialed ABA provider is identified: a master’s- or doctoral-level BCBA, or a licensed behavioral health clinician credentialed for ABA. A BCaBA or non-licensed individual works under the direct supervision of that BCBA or clinician, who "takes responsibility for the individual’s care." [2]

## What intake should collect for UnitedHealthcare / Optum in Idaho

- **Plan funding type:** Fully insured (Bulletin 18-02 applies) or self-funded ERISA (outside it).
- **Diagnosis report with the tool named:** DSM-5-TR ASD plus severity, confirmed with a validated tool such as ADOS-2 or ADI-R.
- **Member ID + card photo:** Request the assessment authorization in Provider Express (One Healthcare ID required) before the first session.
- **Baseline measure:** Treatment intensity must be set from a validated baseline tool, such as VB-MAPP, ABLLS-R, Vineland or SRS.
- **Prescription:** Bulletin 18-02 frames coverage around care prescribed or ordered by a licensed physician or psychologist.

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

## Common questions

### Does UnitedHealthcare require graphs for ABA reassessments?

Optum’s criteria require updated progress data in the same measures used at baseline (mastery rates, change scores, updated standardized adaptive measures) at every continued review; they do not require graphs as such.

### Does UnitedHealthcare accept H0031 or H0032 for ABA?

Optum’s commercial ABA reimbursement policy lists only CPT 97151–97158, 0362T and 0373T as reimbursable ABA codes, each with a credential modifier; no H-code (H0031, H0032, H2014, H2019) is on the list.

### Does UnitedHealthcare cover ABA therapy in Idaho?

Yes, for ASD under Optum’s ABA Supplemental Clinical Criteria. Optum’s State Mandates supplement has no Idaho entry, so the national criteria apply. On state-regulated plans Idaho’s Bulletin 18-02 also bars autism-treatment exclusions.

### Does the UnitedHealthcare ABA assessment need authorization?

Yes. In Provider Express, ABA assessment and ABA treatment are requested as separate authorizations.

### Is there a UnitedHealthcare Medicaid plan for ABA in Idaho?

No. Idaho Medicaid has no managed-care plan for children’s ABA. It is fee-for-service CHIS through the state, so a UnitedHealthcare card on an Idaho child is a commercial or employer plan.

### How often does UnitedHealthcare (Optum) reauthorize ABA?

Optum, which manages UnitedHealthcare’s behavioral health benefits, says “At a minimum, most treatment reviews are required every 4-6 months depending on the account/state law.” Call in the continued-care request “no more than 30 days prior to the current approvals on file expiring,” with updated progress data measured the same way as baseline and updated standardized measures. There is no fixed reassessment frequency (“There is no required frequency at which an assessment must take place”) — ask for reassessment hours inside the treatment request. If more hours are needed mid-authorization, call the ABA team with a clinical rationale.

### Does UnitedHealthcare (Optum) require RBT certification for ABA technicians?

Optum's ABA criteria say technicians "should be registered behavior technicians (RBT) or another appropriately certified behavior technician as allowable by state mandate," working under BCBA or licensed-clinician supervision. They also advise against a parent serving as the RBT for their own child.

### Can the ABA assessment be done by telehealth with UnitedHealthcare?

No, not on commercial plans. Optum's telehealth billing guide allows only 97155, 97156 and 97157 by telehealth for ABA, so 97151 and 97152 are delivered in person. Supervision (97155) and caregiver training can be remote once the provider has completed Optum's virtual-visits attestation.

### What is UnitedHealthcare’s timely filing limit in Idaho?

Optum Behavioral Health, which manages UnitedHealthcare’s ABA benefit, requires claims within 90 calendar days of the date of service unless state or federal law or the member’s plan allows longer (National Network Manual, effective September 1, 2026).

### How fast must UnitedHealthcare pay a clean ABA claim in Idaho?

Idaho law (Idaho Code § 41-5602) requires a fully insured plan to pay or deny an electronic claim within 30 days of receipt (45 for paper) — but only when the claim was filed within 30 days of the service (45 for paper), and a contract with different payment terms overrides it. Self-funded employer plans are not bound by the statute.

### Does UnitedHealthcare require a referring provider (box 17) on ABA claims?

No. Optum’s claim requirements do not include a referring provider. UnitedHealthcare makes the referring name and NPI mandatory only for lab, DME, imaging and home health claims. For other claims it encourages the referring NPI but does not require it.

## Primary sources

1. [2026 UnitedHealthcare Care Provider Administrative Guide (Commercial): Timely filing of corrected claims; Subrogation and COB](https://www.uhcprovider.com/content/dam/provider/docs/public/admin-guides/2026-UHC-Administrative-Guide.pdf)
2. [Optum ABA Supplemental Clinical Criteria (BH803ABASCC; annual review 8/2025, interim review 4/2026)](https://public.providerexpress.com/content/dam/ope-provexpr/us/pdfs/clinResourcesMain/autismABA/abaSCC.pdf)
3. [Optum — ABA State Mandates supplemental criteria (BH 803ABA, eff. July 2026; no Idaho entry)](https://public.providerexpress.com/content/dam/ope-provexpr/us/pdfs/clinResourcesMain/guidelines/scc/ABA_SCC_SM.pdf)
4. [Optum Provider Express — ABA services page (assessment and treatment authorizations)](https://public.providerexpress.com/content/ope-provexpr/us/en/clinical-resources/autismABA2.html)
5. [Idaho Department of Insurance — Bulletin No. 18-02, Clarification Regarding Coverage of Treatments for Autism Spectrum Disorder (April 2, 2018)](https://doi.idaho.gov/bulletin/18-02-clarification-regarding-coverage-of-treatments-for-autism-spectrum-disorder/)
6. [BACB — U.S. Licensure of Behavior Analysts (Idaho not listed; map updated June 2026)](https://www.bacb.com/u-s-licensure-of-behavior-analysts/)
7. [Idaho Code § 41-3930 — Managed care utilization management program requirements](https://legislature.idaho.gov/statutesrules/idstat/Title41/T41CH39/SECT41-3930/)
8. [29 CFR 2560.503-1 — ERISA claims procedure (eCFR)](https://www.ecfr.gov/current/title-29/section-2560.503-1)
9. [IDAPA 18.04.14 — Coordination of Benefits (Idaho Department of Insurance)](https://proddfmmainsa.blob.core.windows.net/dfm-admin-website/rules/current/18/180414.pdf)
10. [Optum — FAQ: Autism/ABA Using CPT Codes (BH00083-24-FAQ, 01/2024)](https://public.providerexpress.com/content/dam/ope-provexpr/us/pdfs/clinResourcesMain/autismABA/abaCPT-FAQs.pdf)
11. [Optum — ABA Reimbursement Policy, Commercial (2022RP501A, updated 06/2026)](https://public.providerexpress.com/content/dam/ope-provexpr/us/pdfs/clinResourcesMain/guidelines/reimbPolicies/abaReimburs2020s.pdf)
12. [Optum — Telehealth Billing Quick Reference Guide (BH01511, updated September 2025)](https://public.providerexpress.com/content/dam/ope-provexpr/us/pdfs/home/Telehealth_Billing_Guide_Updates.pdf)
13. [Optum — Medical Records Documentation for Reviews of ABA Services (BH02325, 6/1/2026)](https://public.providerexpress.com/content/dam/ope-provexpr/us/pdfs/clinResourcesMain/autismABA/OBHS_ABA_Services_Documentation_Protocols.pdf)
14. [Idaho Code § 41-5602 — Prompt payment of claims](https://legislature.idaho.gov/statutesrules/idstat/Title41/T41CH56/SECT41-5602/)
15. [Idaho Code § 41-5603 — Interest payments](https://legislature.idaho.gov/statutesrules/idstat/Title41/T41CH56/SECT41-5603/)
16. [Idaho Code § 41-5605 — Exceptions](https://legislature.idaho.gov/statutesrules/idstat/Title41/T41CH56/SECT41-5605/)
17. [Optum Behavioral Health National Network Manual (published July 1, 2026; effective Sept. 1, 2026)](https://public.providerexpress.com/content/dam/ope-provexpr/us/pdfs/adminResourcesMain/netwmanual/NNManual.pdf)
18. [Idaho Medicaid Provider Handbook — General Information and Requirements for Providers (December 23, 2025)](https://www.idmedicaid.com/General%20Information/General%20Information%20and%20Requirements%20for%20Providers.pdf)
19. [10 U.S.C. 1079(i)(1) — TRICARE pays after other coverage except Medicaid](https://www.govinfo.gov/content/pkg/USCODE-2023-title10/html/USCODE-2023-title10-subtitleA-partII-chap55-sec1079.htm)
20. [38 CFR 17.270 — CHAMPVA is the last payer](https://www.ecfr.gov/current/title-38/section-17.270)

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.