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New Jersey Medicaid ABA Program
The process for requesting ABA services has gone digital
Effective November 18, 2024, the process for requesting ABA services has changed. Our new digital process saves time and is part of our commitment to making working with us easier.
Learn the new steps on your time
What to have ready for your ABA request
Provider data: Name, address, NPI and TIN
Member data: Name, address and Member ID*
*Member ID search is a feature in the digital request.
Submit a digital ABA services request
Log in to the Provider Express secure portal
Select 'Auths' from the upper right menu
Click the 'Auth request' tab
Choose 'Request a new authorization'
Select ABA Assessment from the drop down menu
Complete the required fields and submit
Other ABA authorization submissions can be started here.
Other ABA treatment submissions can be started here.
UnitedHealthcare Community Plan is one of the selected managed care plans providing coverage to New Jersey FamilyCare members. Optum has been selected by UnitedHealthcare Community Plan to develop and manage the ABA network for New Jersey FamilyCare members, effective 4/1/2020. Your participation in our network helps to ensure access to comprehensive quality care for covered behavioral health services for enrolled members.
To assist you in your participation in this program, learn more about the process for applying to the network, and the clinical protocols required in this unique network, please review the resource materials below
- New Jersey FamilyCare Medicaid ABA Orientation
- NJ ABA QRG (updated version 4.26.21)
- DMAHS Guide to Autism Services
Developmental Services
Effective July 1, 2020 the Division of Medical Assistance and Health Services (DMAHS) launched coverage for the provision of Developmental Services to support families with children diagnosed with Autism Spectrum Disorder (ASD). For the purposes of eligibility, these services are available to any NJ FamilyCare/Medicaid (NJFC/M) eligible child, under the age of twenty-one, who has been diagnosed with ASD, as defined by ICD-10 diagnosis codes F84.0 through F84.9, by a qualified healthcare provider.
- New Jersey FamilyCare Medicaid DIR Orientation (updated version 4.26.21)
- NJ DRBI QRG (updated version 4.26.21)
Contact Us/Request to Join the Network
Shailja Patel
Specialty Network Manager
shailja.patel@optum.com
