Applied Behavior Analysis
Applied Behavior Analysis (ABA) is a highly individualized form of behavioral therapy.
ABA services are commonly prescribed for many children and adults who have been diagnosed with autism. Services are provided in various settings, including schools, communities, and homes. When delivered by qualified ABA providers, ABA has been proven to help autistic individuals gain new skills and reduce behaviors that negatively impact their quality of life.
ABA Requirements
An updated Optum Behavioral Health national network manual was recently released and is effective Aug. 15, 2024.
ABA information in the manual is now consistent with a requirement that Optum has had in place since 2018. Specifically, all paraprofessionals or behavior technicians are required to be a Registered Behavior Technician (RBT) in order for services they render to be eligible for reimbursement. This is in line with industry standards and best practices.
Note: State regulatory requirements may supplement, modify, or in some cases, supersede this requirement.
Questions? Contact your Optum Provider Advocate.
Commercial ABA Program
- FAQ - ABA Using CPT Codes
- ABA Agency Provider Orientation
- ABA Agency Quick Reference Guide
- ABA virtual visits
Provider Express Resources & Tutorials
- Overview of online tools that improve workflow and efficiency
- How to become a registered Provider Express user (Brief video overview of obtaining your Optum ID)
- ABA online eligibility and benefit inquires (Brief how-to video overview)
- How to view ABA authorizations online (You see what we see - brief video overview)
ABA Treatment Requests
ABA Review Process
ABA Assessment Portal
- Online ABA Assessment Requests - REQUIRED electronic submission
- New Mexico Electronic Assessment Requests - New Mexico Providers REQUIRED to use this request form
ABA Treatment Request Documents (forms to coordinate the approval process with an Autism Care Advocate)
- Guidelines for ABA Services Using CPT Codes
- Guidelines for Pennsylvania BHRS Services Only Using CPT Codes
- Request Form for Indiana ABA Services ONLY
- Request Form for Commercial in California, Indiana, New Jersey, New Mexico, Ohio, Tennessee, Washington and West Viriginia - electronic submission
- Request Form for Commercial Arizona Fully Insured - electronic submission
- Arizona Standard Prior Auth Request: Arizona Fully Insured Only
Fax to 888-541-6691 - If you have been directed by a letter requesting additional information by our National ABA Team click here to submit
- Request for UHSS/SUREST/NTCA providers - electronic submission
The Optum ABA Network
Our ABA network is made up of hundreds of master’s and doctoral-level board-certified Behavior Analysts.
All applications to join the network are reviewed to determine whether an applicant meets our education, training and licensure requirements for participation. Applications are also reviewed against geographic network need for member access.
Interested in being considered for our network? Review the information on this page to understand our ABA clinical protocols, processes and requirements. Then, submit an application.
State Medicaid ABA Programs
Alaska Medicaid Autism Services
Arizona AHCCCS ABA Program
California Medi-Cal ABA Program
Hawaii QUEST ABA Program
Louisiana Healthy LA ABA Program
Idaho Medicaid Behavior Modification and Consultation Program
Indiana Medicaid ABA Program
Kansas KanCare Autism Program
Kentucky Medicaid ABA Program
Mass. General Brigham Health Plan
Minnesota Medicaid EIDBI Program
Mississippi CAN / CHIP Autism Program
North Carolina Medicaid Research-Based Intensive Behavioral Health Treatment Program
Nebraska Heritage Health ABA Program
New Jersey Medicaid ABA Program/Developmental Services
New York Medicaid ABA Program
New Mexico Turquoise Care ABA Program
Ohio Medicaid ABA Program
Pennsylvania Chip ABA Program
Tennessee Medicaid ABA Program
Texas Medicaid ABA Program
Virginia Medicaid MHS ABA Program
Washington Medicaid ABA Program
ABA Retrospective Review Process
Guidelines/Manual
ABA Agency Site Audit and Record Review Tools (sample forms that are utilized during the ABA Agency credentialing/site audit review and resource guide)