Need help with the Provider Express secure portal?
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1-866-209-9320.
New York Medicaid ABA Program
A streamlined way for all ABA providers to manage services
Both network and out-of-network providers manage ABA services in the Provider Express secure portal. A One Healthcare ID (OHID) is required to access the portal.
The self-paced guide provides step-by-step instructions for how to register for a One Healthcare ID and access the portal for the first time.
Use the Provider Express secure portal to:
- Verify ABA Coverage and eligibility
- Request ABA assessment and treatment authorizations
- Submit additional information to the clinical team upon request
- View real-time status updates on your requests
Prior Authorization requests
Prepare your prior authorization request
Refer to our submission checklist QRG to ensure you have all the required information. A complete submission helps prevent processing delays.
- Review the ABA clinical review requirements
- Provider data: Name, address, NPI and TIN
- Member data: Name, address and Member ID*
Use these self-paced guides to learn how to:
Verify ABA eligibility and benefits
Submit an ABA prior authorization request
Get the status of submitted ABA authorization requests
Submit an authorization request in 5 steps
1. Select 'Auths' from the upper right menu
2. Click the 'Auth request' tab
3. Choose 'Request a new authorization'
4. Select ABA Assessment or Treatment from the drop down
5. Complete the required fields and submit
Note: Effective 2/1/2024, services with a place of services school (03) including preschools are not covered.
UnitedHealthcare Community Plan is one of the selected managed care plans providing coverage to New York Child Health Plus (CHP)and New York Essential Plan Plus (EPP) members. Optum has been selected by UnitedHealthcare Community Plan to develop and manage the ABA network for New York CHP and EPP members. Your participation in our network helps to ensure access to comprehensive quality care for covered behavioral health services for enrolled members.
Effective April 4, 2023, New York State Department of Health (NYSDOH) added the following two CPT codes for ABA service for New York Medicaid Managed Care children under 21:
- CPT code 97154
- CPT code 97157
For more, please see the April 2023 NYSDOH bulletin detailing these additional codes: New York State Medicaid Update - March 2023 Volume 39 - Number 6
Effective January 1, 2023, UnitedHealthcare Community Plan is one of the selected managed care plans providing coverage to New York Medicaid members. Optum has been selected by UnitedHealthcare Community Plan to develop and manage the ABA network for New York Medicaid 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 York CHP and EPP ABA Provider Orientation
- New York CHP ABA and EPP Provider Quick Reference Guide
- New York ABA Medicaid Provider Orientation
- New York ABA Medicaid Quick Reference Guide
Contact Us/Request to Join the Network
Call Provider Relations at 1-877-614-0484.
